Anti-igf antibodies

ABSTRACT

Antibody molecules, in particular fully human antibodies that bind to human IGF-1 and cross-react with IGF-2 such that binding of IGF-1 and IGF-2 to the IGF-1 receptor is prevented and IGF-1 receptor-mediated signaling is inhibited. The antibodies do not bind to insulin and thus do not affect the mitogenic properties of insulin that are mediated by its binding to the insulin receptors. The antibodies are useful for the treatment of hyperproliferative diseases, in particular cancer.

This application is a Continuation application of U.S. application Ser.No. 13/653,843 filed Oct. 17, 2012, which is a Divisional application ofU.S. application Ser. No. 12/636,195 filed Dec. 11, 2009, which claimsthe benefit of European application number EP 08171554.2 filed Dec. 12,2008, the contents of which are incorporated herein their entirety.

The present invention relates to the therapy of hyperproliferativediseases, in particular to the therapy of cancers.

BACKGROUND OF THE INVENTION

Insulin-like growth factor-1 (IGF-1; a 70 amino-acid polypeptide) andinsulin-like growth factor-2 (IGF-2; a 67 amino-acid polypeptide) are7.5-kD soluble factors present in serum that can potently stimulate thegrowth of many mammalian cells (reviewed by Pollack et al., 2004). Onsecretion into the bloodstream the IGFs form complexes with the IGFBPswhich protect them from proteolytic degradation in the serum en route totheir target tissues and prevents their association with the IGFreceptors. IGFs are also known to be secreted in an autocrine orparacrine manner in target tissues themselves. This is known to occurduring normal fetal development where the IGFs play a key role in thegrowth of tissues, bone and organs. It is also seen in many cancertissues where there is thought to be paracrine signaling between tumourcells and stromal cells or autocrine IGF production by the tumour cellsthemselves (reviewed by LeRoith D, 2003).

IGF-1 and IGF-2 are able to bind to the IGF-1 receptor (IGF-1R)expressed on many normal tissues, which functionally is a 460 kDheterotetramer consisting of a dimerised alpha- and beta-subunit, withsimilar affinities (Rubin et al., 1995). IGF-2 can also bind to theIGF-2 receptor, which is thought to prevent IGF-2 from binding andsignaling through the IGF-1R. In this respect the IGF-2R has beendemonstrated to be a tumour suppressor protein. The IGF-1R isstructurally similar to the insulin receptor which exists in two forms,IR-A and IR-B, which differ by an alternatively spliced 12 amino acidexon deletion in the extracellular domain of IR-A. IR-B is thepredominant IR isoform expressed in most normal adult tissues where itacts to mediate the effects of insulin on metabolism. IR-A on the otherhand is known to be highly expressed in developing fetal tissues but notin adult normal tissues. Recent studies have also shown that IR-A, butnot IR-B, is highly expressed in some cancers. The exon deletion in IR-Ahas no impact on insulin binding but does cause a small conformationalchange that allows IGF-2 to bind with much higher affinity than for IR-B(Frasca et al., 1999; Pandini et al., 2002). Thus, because of it'sexpression in cancer tissues and increased propensity for IGF-2 binding,IR-A may be as important as IGF1-R in mediating the mitogenic effects ofIGF-2 in cancer.

Binding of the IGFs to IGF-1R triggers a complex intracellular signalingcascade which results in activation of proteins that stimulateproliferation and survival (reviewed by Pollack et al., 2004).

Unlike the EGFR and Her2neu receptors there is no known amplification ofthe IGF1-R or IR-A receptors in cancers indicating that receptoractivation is controlled by the presence of active ligand. There is avery large body of scientific, epidemiological and clinical literatureimplicating a role for the IGFs in the development, progression andmetastasis of many different cancer types (reviewed by Jerome et al.,2003; and Pollack et al., 2004).

For example, in colorectal cancer the expression of IGF-2 mRNA andprotein is elevated in clinical colorectal tumour specimens comparedwith adjacent normal tissue (Freier et al., 1999; Li et al., 2004).There is also a positive correlation of elevated IGF serum levels withproliferating cell index in patients with colorectal neoplasia (Zhao etal., 2005). In addition, elevated circulating levels of IGF-2 correlatewith an increased risk of developing colorectal cancers and adenomas(Renehan et al., 2000a) and b); Hassan et al., 2000). Loss of parentalimprinting (LOI) of the IGF-2 gene, an epigenetic alteration thatresults in elevated IGF-2 expression, is a heritable molecular traitthat has recently been identified in patients with colorectal and othertumour types. Loss of IGF-2 imprinting has been shown to be associatedwith a five-fold risk of colorectal neoplasia (Cui et al., 2003;Cruz-Correa et al., 2004) and adenomas (Woodson et al., 2004).Antibodies targeting the alpha-subunit of the IGF-1R which block IGFbinding and internalize the receptor have been shown to delay the growthof the xenografted colon cancer-derived cell lines such as COLO 205(Burtrum et al., 2003).

Elevated levels of IGFs are associated with a poor prognosis in humanpulmonary adenocarcinomas (Takanami et al., 1996) and IGFs are expressedand secreted by many SCLC- and NSCLC-derived cell lines (Quinn et al.,1996). Transgenic over-expression of IGF-2 induces spontaneous lungtumours in a murine model (Moorhead et al., 2003). In terms ofhepatocellular carcinoma (HCC), human clinical specimens and animalmodels of HCC express higher levels of IGF mRNA and protein thancorresponding normal tissues and this has been correlated with increasedtumour growth (Wang et al., 2003; Ng et al., 1998). IGF-2 has also beenshown to be a serological marker of HCC with elevated levels in theserum of HCC patients compared with controls (Tsai et al., 2005).

Many childhood solid tumours such as Ewing's sarcoma andrhabdomyosarcoma appear to be particularly dependent on the IGFsignaling pathway for their growth (Scotlandi et al., 1996). LOI of theIGF-2 gene has been implicated as a primary genetic event in thedevelopment for embryonal rhabdomyosarcoma (Fukuzawa et al., 1999).Autocrine IGF signaling is also thought to strongly influence the growthof Ewing's sarcoma in cases where the type-1 EWS-FLI1 chimerictranscription factor is expressed through a chromosomal translocationresulting in elevated expression of target genes including the IGFligands and IGF-1R, and reduced expression of IGFBP-3. Antibodies andsmall molecule compounds targeting the IGF-1R have been shown to reducethe growth of xenografted pediatric solid tumour derived cell lines(Kolb et al., 2008; Manara et al., 2007).

Using IGF ligand-specific antibodies it has been demonstrated that thegrowth of human prostate cancer cells in adult human bone implanted intoSCID mice can be inhibited (Goya et al., 2004). In addition, it wasdemonstrated that the same IGF ligand antibodies could block theparacrine supply of IGF and suppress the liver metastasis of humancolorectal cancer cells in a murine xenograft system (Miyamoto et al.,2005).

There is also considerable evidence suggesting that the IGF signalingsystem reduces the sensitivity of cancers to chemotherapeutic agents andradiation. One of the earliest findings in this respect was thedemonstration that IGF-1R knock-out mouse embryos are refractory totransformation by viruses, oncogenes and over-expressed growth factorreceptors (Sell et al., 1993; Sell et al., 1994) and thatover-expression of IGF-1R protects cells from UV irradiation and gammaradiation-induced apoptosis (Kulik et al., 1997). Furthermore, usingliver tumour cell lines that secrete large amounts of IGF-2, it wasfound that neutralization of IGF-2 significantly increased response tochemotherapeutic agents such as cisplatin and etoposide in vitro,especially at lower, cytostatic doses, suggesting that IGF-2 can reducethe susceptibility to chemotherapeutic agents (Lund et al., 2004).Consistent with these findings it has been demonstrated that antibodiestargeting the IGF-1R increase the susceptibility of tumour xenografts togrowth inhibition by chemotherapeutic drugs and radiation (Goetsch etal., 2005).

A number of antibodies that show cross-reactive binding to human IGF-1and human IGF-2 have been reported. Antibody sm1.2 was raised againsthuman IGF-1 and shows 40% cross-reactivity to human IGF-2 and was shownto inhibit the proliferation of a mouse fibroblast cell line BALB/c3T3which was stimulated with 20 ng/ml human IGF-1 (Russell et al., 1984).In a study designed to functionally epitope map IGF-1 by raisingmonoclonal antibodies to whole IGF-1 protein and portions of the proteina number of antibodies where identified that cross reacted with IGF-2(Manes et al., 1997). The percent cross-reactivity with IGF-2 rangedfrom 0 to 800% and several antibodies were identified which were equallyIGF-1 and IGF-2 reactive. KM1486 is a rat monoclonal antibody thatcross-reacts with human IGF-1 and IGF-2 and it was demonstrated thatKM1486 can inhibit growth of human prostate cancer cells in human adultbone implanted into nonobese diabetic/severe combined immunodeficientmice (Goya et al., 2004). In addition, it was demonstrated that KM1486suppresses the liver metastasis of human colorectal cancers (Miyamoto etal., 2005). KM1486 has also been described in WO 03/093317, JP2003-310275, WO 2005/018671, WO 2005/028515, and WO 2005/027970.

For the treatment of human disease an antibody with a fully humansequence is highly desirable in order to minimize the risk of generatinga human anti-antibody reaction and neutralizing antibodies that willrapidly eliminate the administered antibody from the body and therebyreduce the therapeutic effect. As such, and given the roles of IGF-1 andIGF-2 dependent signaling in the development and progression of cancers,it has become desirable to obtain fully human antibodies. WO 2007/070432describes fully human antibodies that co-neutralise the mitogeniceffects of both ligands.

It was an object of the invention to provide alternative human anti-IGFantibodies with high affinities.

It was a further object of the invention to provide human anti-IGFantibodies with high affinity to IGF-1.

It was a further object of the invention to provide human anti-IGFantibodies with high affinity to IGF-1 and to IGF-2.

It was a further object of the invention to provide human anti-IGFantibodies with adequate relative affinities to IGF-1 and to IGF-2.

It was a further object of the invention to provide human anti-IGFantibodies with a higher affinity to IGF-1 than to IGF-2.

It was a further object of the invention to provide human anti-IGFantibodies with high IGF-1 neutralisation potency.

It was a further object of the invention to provide human anti-IGFantibodies with high IGF-1 and IGF-2 neutralisation potency.

It was a further object of the invention to provide human anti-IGFantibodies with high solubility and stability.

It was a further object of the invention to obtain antibodies that donot affect binding of insulin to its receptor.

The clinical development of therapeutic agents is supported bypharmacodynamic biomarkers of drug activity. Clinical studies withantibodies targeting the IGF-1R have demonstrated that an increase intotal serum IGF-1 levels may be a useful pharmacodynamic marker forthese agents (Pollack et al., 2007). The reason for the increase intotal serum IGF-1 levels is likely due to a feedback mechanism involvingpituitary growth hormone (GH) secretion which releases both IGF-1 andIGFBPs from the liver. Indeed, in humans it has been demonstrated thatfree or bioactive IGF-1, which represents only around 1% of total IGF-1levels, determines the feedback response (Chen et al., 2005).

It was therefore a further object of the invention to provide, for thetreatment of diseases in whose development and/or progression the IGFsare causally involved, a therapy that is accompanied by a biomarker thatallows the pharmacological monitoring of the effectiveness of thetherapy.

In the experiments of the present invention, it could be demonstratedthat total serum IGF-1 levels are elevated upon application of theanti-IGF antibodies of the invention. Thus, total IGF-1 levels are auseful pharmacodynamic marker for the effectiveness of the therapy withan anti-IGF antibody. It is therefore highly advantageous that theantibodies of the invention are cross-reactive with IGFs from a suitableanimal species, e.g. mouse or rat, such that a pharmacodynamic effectcan already be tested pre-clinically.

“Total IGF-1 levels” refers to the combined amount of IGF-1 in plasma orserum comprising the amount of IGF-1 bound to serum binding proteinsplus the free (unbound) IGF-1.

Therefore, in a further aspect, the present invention relates to amethod for determining the effectiveness of a treatment of a cancerpatient with an antibody molecule that binds to IGF-1 and IGF-2. In suchmethod, in a first step, the level of total IGF-1 is measured in abiological sample of the patient, e.g. serum or plasma. Next, theantibody molecule is administered and then, after a period of timesufficient to allow the therapeutic antibody to exert its effect, thelevel of total IGF-1 is again determined. The amount of increase in thelevel of total IGF-1 compared to the level of total IGF-1 measured inthe first step, indicates to which extent the patient responds to saidanti-IGF antibody molecule. This method is preferably used formonitoring therapies in which the antibodies of the invention areadministered.

BRIEF DESCRIPTION OF THE FIGURES

FIGS. 1A-1G show an ELISA binding titration of IgG1 antibodiesdesignated 60814, 60819 and 60833 to human IGF-1 (FIG. 1A), mouse IGF-1(FIG. 1B), rat IGF-1 (FIG. 1C), human IGF-2 (FIG. 1D), mouse IGF-2 (FIG.1E), rat IGF-2 (FIG. 1F), and human insulin (FIG. 1G).

FIGS. 2A-2B show typical titrations of antibody 60833 neutralising IGF-1(20 ng/mL)(FIG. 2A) and IGF-2 (100 ng/mL) (FIG. 2B) inducedphosphorylation of the IGF-1R using a cell based ELISA.

FIG. 3A shows a typical titration of antibody 60833 neutralising IGF-2(100 ng/mL) induced IR-A phosphorylation. FIG. 3B shows a typicaltitration of antibody 60833 neutralising human serum (20%) inducedphosphorylation of the IGF-1R. Both assays are performed using cellbased ELISAs.

FIGS. 4A-4D show the effect of antibodies 60814 and 60819 on IGF-1(FIGS. 4A and 4C) and IGF-2 (FIGS. 4B and 4D) stimulated MCF-7 (FIGS. 4Aand 4B) and COLO 205 (FIGS. 4C and 4D) cell proliferation.

FIG. 5 shows the effect of antibodies 60819 and 60833 on theproliferation of the Ewing's sarcoma-derived cell line TC-71 in 10%growth medium.

FIG. 6 shows the effect of antibody 60819 on murine total serum IGF-1levels 24 hours following the administration of single doses of 25,12.5, 6.25, 3.13 mg/kg. 0 mg/kg represents the total serum IGF-1 levelsprior to antibody treatment.

FIG. 7 shows the effect of antibody 60819 on rat total plasma IGF-1levels 24 hours following the administration of single doses of 30, 100,200 mg/kg by a 10 minute intravenous infusion. 0 mg/kg represents thetotal serum IGF-1 levels prior to antibody treatment.

FIG. 8 demonstrates the effect of antibody 60819 and rapamycin, alone orin combination, on the proliferation of the Ewing's sarcoma-derived cellline SK-ES-1 in 10% FCS containing growth medium.

FIG. 9 shows the effect of antibody 60819 and rapamycin, alone or incombination, on the phosphorylation of AKT and levels of PTEN.

FIG. 10 demonstrates the effect of antibody 60819 and erlotinib/Tarceva,alone or in combination, on the proliferation of the NSCLC-derived cellline A-549 in 10% FCS containing growth medium.

FIG. 11 shows the 3D structure of human IGF-1 where the amino acidsbound by antibody 60833 are highlighted (dark grey). The linear aminoacid sequence of human IGF-1 where the amino acids that interact withantibody 60833 are underlined is shown underneath (SEQ ID NO: 43).

FIGS. 12A-12C show the amino acid and DNA sequences of the variablechains of antibodies 60814 (FIG. 12A, SEQ ID NOs: 7 and 8, and SEQ IDNOs: 9 and 10), 60819 (FIG. 12B, SEQ ID NOs: 17 and 18, and SEQ ID NOs:19 and 20), and 60833 (FIG. 12C, SEQ ID NOs: 27 and 28, and SEQ ID NOs:29 and 30); CDRs are in bold letters.

BRIEF DESCRIPTION OF INVENTION

In one aspect, the present invention relates to an isolated humanantibody molecule, which

a) binds to human IGF-1 and IGF-2 such that

-   -   i) binding of IGF-1 and IGF-2 to the IGF-1 receptor is prevented        and    -   ii) IGF-1 receptor-mediated signaling is inhibited,        b) binds to mouse and rat IGF-1 and IGF-2,        c) does not bind to human insulin;        wherein said antibody molecule is selected from the group        comprising    -   i) an antibody molecule that has heavy chain CDRs comprising the        amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2)        and SEQ ID NO:3 (CDR3) and that has light chain CDRs comprising        the amino acid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5        (CDR2) and SEQ ID NO:6 (CDR3);    -   ii) an antibody molecule that has heavy chain CDRs comprising        the amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12        (CDR2) and SEQ ID NO:13 (CDR3) and that has light chain CDRs        comprising the amino acid sequences of SEQ ID NO:14 (CDR1), SEQ        ID NO:15 (CDR2) and SEQ ID NO:16 (CDR3);    -   iii) an antibody molecule that has heavy chain CDRs comprising        the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22        (CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs        comprising the amino acid sequences of SEQ ID NO:24 (CDR1), SEQ        ID NO:25 (CDR2) and SEQ ID NO:26 (CDR3).

In another aspect, the present invention relates to an anti-IGF antibodymolecule, wherein said antibody molecule has heavy chain CDRs comprisingthe amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) andSEQ ID NO:3 (CDR3) and light chain CDRs comprising the amino acidsequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6(CDR3).

In another aspect, the present invention relates to an anti-IGF antibodymolecule, wherein said antibody molecule has heavy chain CDRs comprisingthe amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) andSEQ ID NO:13 (CDR3) and light chain CDRs comprising the amino acidsequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ ID NO:16(CDR3).

In another aspect, the present invention relates to an anti-IGF antibodymolecule, wherein said antibody molecule has heavy chain CDRs comprisingthe amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) andSEQ ID NO:23 (CDR3) and has light chain CDRs comprising the amino acidsequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26(CDR3).

In another aspect, the present invention relates to anti-IGF antibodymolecules having heavy and light chains or CDRs having amino acidsequences as depicted in FIG. 12A-C.

In another aspect, the present invention relates to an anti-IGF antibodymolecule, wherein said antibody molecule binds to a nonlinear epitopewithin IGF-1 comprising the amino acid sequences LCGAELVDALQFVCGDR (SEQID NO:41) and CCFRSCDLRRLEM (SEQ ID NO:42) of human IGF-1 (SEQ IDNO:43). In a preferred embodiment, said antibody molecule makes contactwith at least 8 amino acids within the amino acid sequenceLCGAELVDALQFVCGDR (SEQ ID NO:41), and at least 10 amino acids withinamino acid sequence CCFRSCDLRRLEM (SEQ ID NO:42) of human IGF-1 (SEQ IDNO:43). In a further preferred embodiment, such anti-IGF antibodymolecule makes contact with Leu (5), Cys (6), Glu (9), Leu (10), Asp(12), Ala (13), Phe (16), Val (17), Arg (21), Cys (47), Cys (48), Phe(49), Ser (51), Cys (52), Asp (53), Leu (54), Arg (55), Leu (57), andGlu (58) of human IGF-1 (SEQ ID NO:43), as determined by X-raycrystallography. A respective method is disclosed in Example 9 herein.Preferably, said antibody molecule has heavy chain CDRs comprising theamino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) and SEQID NO:23 (CDR3) and has light chain CDRs comprising the amino acidsequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26(CDR3).

Binding of the antibody is defined as the interaction that occurs viathe non-covalent bonds that hold the antigen (or a protein or a fragmentthereof that is structurally similar) to the antibody combining site,i.e. the region of the immunoglobulin that combines with the determinantof an appropriate antigen (or a structurally similar protein).

Affinity (i.e. the interaction between a single antigen-binding site onan antibody and a single epitope) is expressed by the associationconstant K_(A)=k_(ass)/k_(diss) or the dissociation constantK_(D)=k_(diss)/k_(ass).

In one aspect according to a), the antibody binds to each IGF proteinwith an affinity, as determined by surface plasmon resonance analysis,with a K_(D) value ranging from 0.02 nM to 20 nm, e.g. 0.2 nM to 2 nM,for example, with an affinity of 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6,0.7, 0.8, 0.9, or 1.0 nM. Based on this property, neutralization of IGFfunctional signaling is achieved.

In one aspect according to c), the antibody does not bind to humaninsulin at concentrations that are at least 100-fold higher than theminimum concentration required for binding to human IGF-1 or IGF-2.

In another aspect, the property of the anti-IGF antibody moleculedefined in c) is characterized by the fact that the affinity of theanti-IGF antibody molecule to IGF-1 and IGF-2, respectively, is at least100-fold, and even more than 1000-fold, as compared to its affinity toinsulin. Even though at very high doses, e.g. more than 100 mg/kg, weakbinding may not be completely excluded, the anti-IGF antibody moleculedoes not bind to insulin at therapeutic doses.

In one embodiment, the antibody molecules of the invention do not affectthe mitogenic properties of human insulin that are mediated by itsbinding to the insulin receptor. (In general, a mitogenic property isdefined as the ability of a compound to encourage a cell to commencecell division, triggering mitosis, e.g. in the case of insulin, itsability to promote cell growth).

In another embodiment, in addition to its ability to inhibit IGFsignaling mediated via the IGF-1 receptor, an antibody of the inventionalso has the ability to inhibit IGF-2 signaling mediated via the insulinreceptor IR-A.

The antibodies of the invention have a surprisingly high neutralisationpotency towards IGF-1 and IGF-2. Furthermore, they have an unexpectedhigher potency and binding affinity towards IGF-1 than towards IGF-2.They have high solubility and stability, they are free of undesirableglycosylation or hydrolysis motifs in the variable domain, and have along half-life in the circulation.

DETAILED DESCRIPTION OF THE INVENTION

In the following, an antibody molecule of the invention, which binds tohuman IGF-1 and IGF-2, is termed “anti-IGF antibody molecule”.

The term “anti-IGF antibody molecule” encompasses human anti-IGFantibodies, anti-IGF antibody fragments, anti-IGF antibody-likemolecules and conjugates with any of the above mentioned antibodymolecules. Antibodies include, in the meaning of the present invention,but are not limited to, monoclonal, chimerized monoclonal, and bi- ormultispecific antibodies. The term “antibody” shall encompass completeimmunoglobulins as they are produced by lymphocytes and for examplepresent in blood sera, monoclonal antibodies secreted by hybridoma celllines, polypeptides produced by recombinant expression in host cells,which have the binding specificity of immunoglobulins or monoclonalantibodies, and molecules which have been derived from suchimmunoglobulins, monoclonal antibodies, or polypeptides by furtherprocessing while retaining their binding specificity.

In particular, the term “antibody molecule” includes fully humancomplete immunoglobulins comprising two heavy chains and two lightchains, preferably.

In a further aspect, the antibody molecule is an anti-IGFantibody-fragment that has an antigen binding region. To obtain antibodyfragments, e.g. Fab fragments, digestion can be accomplished by means ofroutine techniques, e.g. using papain or pepsin. Examples of papaindigestion are described in WO 94/29348 and U.S. Pat. No. 4,342,566.Papain digestion of antibodies typically produces two identical antigenbinding fragments, so-called Fab fragments, each with a single antigenbinding site, and a residual Fc fragment. Pepsin treatment yields anF(ab′)₂ fragment that has two antigen combining sites and is stillcapable of cross-linking the antigen. Antibody fragments can also begenerated by molecular biology methods producing the respective codingDNA fragments.

Fab fragments also contain the constant domains of the light chain andthe first constant domain (CH₁) of the heavy chain. Fab′ fragmentsdiffer from Fab fragments in that they contain additional residues atthe carboxy terminus of the heavy chain CH₁ domain including one or morecysteines from the antibody hinge region. Fab′-SH is the designationherein for Fab′ in which the cysteine residue(s) of the constant domainsbear a free thiol group. F(ab′)₂ antibody fragments originally wereproduced as pairs of Fab′ fragments which have hinge cysteines betweenthem.

Antigen-binding antibody fragments or antibody-like molecules, includingsingle-chain antibodies and linear antibodies as described in Zapata etal., 1995, may comprise, on a single polypeptide, the variable region(s)alone or in combination with the entirety or a portion of the following:constant domain of the light chain, CH1, hinge region, CH2, and CH3domains, e.g. a so-called “SMIP” (“Small Modular Immunopharmaceutical”),which is an antibody like molecule employing a single polypeptide chainas its binding domain Fv, which is linked to single-chain hinge andeffector domains devoid of the constant domain CH1 (WO 02/056910). SMIPscan be prepared as monomers or dimers, but they do not assume thedimer-of-dimers structure of traditional antibodies. Also included inthe invention are antigen-binding fragments comprising any combinationof variable region(s) with a constant domain region of a light chain,VH1, CH1, hinge region, CH2, and CH3 domains.

The antibody fragments or antibody-like molecules may contain all oronly a portion of the constant region as long as they exhibit specificbinding to the relevant portion of the IGF-1/IGF-2 antigen. The choiceof the type and length of the constant region depends, if no effectorfunctions like complement fixation or antibody dependent cellulartoxicity are desired, mainly on the desired pharmacological propertiesof the antibody protein. The antibody molecule will typically be atetramer consisting of two light chain/heavy chain pairs, but may alsobe dimeric, i.e. consisting of a light chain/heavy chain pair, e.g. aFab or Fv fragment, or it may be a monomeric single chain antibody(scFv).

The anti-IGF antibody-like molecules may also be single domainantibodies (e.g. the so-called “nanobodies”), which harbour anantigen-binding site in a single Ig-like domain (described e.g. in WO03/050531, and by Revets et al., 2005). Other examples for antibody-likemolecules are immunoglobulin super family antibodies (IgSF; Srinivasanand Roeske, 2005), or CDR-containing or CDR-grafted molecules or “DomainAntibodies” (dAbs). dABs are functional binding units of antibodies,corresponding to the variable regions of either the heavy (VH) or light(VL) chains of human antibodies. Domain Antibodies have a molecularweight of approximately 13 kDa, or less than one-tenth the size of afull antibody. A series of large and highly functional libraries offully human VH and VL dAbs has been developed. dABs are also availablefor “dual targeting”, i.e. dAbs that bind, in addition to IGF-1/IGF-2,to a further target in one molecule. dAb libraries, selection andscreening methods, dAb formats for dual targeting and for conferringextended serum half life are described in e.g. U.S. Pat. No. 6,696,245,WO 04/058821, WO 04/003019, and WO 03/002609.

In general, antibody fragments and antibody-like molecules are wellexpressed in bacterial, yeast, and mammalian cell systems.

In a preferred embodiment, an antibody molecule of the invention, asdefined above in i), has a variable heavy chain comprising the aminoacid sequence of SEQ ID NO:8 and a variable light chain comprising theamino acid sequence of SEQ ID NO:10 (this sequence may contain, at itsC-terminus, an additional Gln. This amino acid position may either beconsidered the C-terminal end of the variable region, according to theKabat numbering, or alternatively, and in line with the sequences in thesequence listing, it may represent the first amino acid of the constantlight chain, see SEQ ID NO:34).

Preferably, an antibody with the variable heavy chain comprising theamino acid sequence of SEQ ID NO:8 and a variable light chain comprisingthe amino acid sequence of SEQ ID NO:10 has an IgG1 constant heavy chainregion. Preferably, such antibody has an Igλ constant light chainregion. Preferably, such antibody is the antibody designated 60814,which has a heavy chain constant region which comprises the amino acidsequence of SEQ ID NO:32 and a light chain constant region whichcomprises the amino acid sequence of SEQ ID NO:34. The complete aminoacid sequences of the antibody designated 60814 are depicted in SEQ IDNO:35 (heavy chain) and SEQ ID NO:36 (light chain).

In another preferred embodiment, an antibody molecule of the invention,as defined above in ii), has a variable heavy chain comprising the aminoacid sequence of SEQ ID NO:18 and a variable light chain comprising theamino acid sequence of SEQ ID NO:20 (this sequence may contain, at itsC-terminus, an additional Gln. This amino acid position may either beconsidered the C-terminal end of the variable region, according to theKabat numbering, or alternatively, and in line with the sequences in thesequence listing, it may represent the first amino acid of the constantlight chain, see SEQ ID NO:34).

Preferably, an antibody with the variable heavy chain comprising theamino acid sequence of SEQ ID NO:18 and a variable light chaincomprising the amino acid sequence of SEQ ID NO:20 has an IgG1 constantheavy chain region. Preferably, such antibody has an Igλ constant lightchain region. Preferably, such antibody is the antibody designated60819, which has a heavy chain constant region which comprises the aminoacid sequence of SEQ ID NO:32 and a light chain constant region whichcomprises the amino acid sequence of SEQ ID NO:34. The complete aminoacid sequences of the antibody designated 60819 are depicted in SEQ IDNO:37 (heavy chain) and SEQ ID NO:38 (light chain).

In another preferred embodiment, an antibody of the invention, asdefined above in iii), has a variable heavy chain comprising the aminoacid sequence of SEQ ID NO:28 and a variable light chain comprising theamino acid sequence of SEQ ID NO:30 (this sequence may contain, at itsC-terminus, an additional Gln. This amino acid position may either beconsidered the C-terminal end of the variable region, according to theKabat numbering, or alternatively, and in line with the sequences in thesequence listing, it may represent the first amino acid of the constantlight chain, see SEQ ID NO:34).

Preferably, an antibody with the variable heavy chain comprising theamino acid sequence of SEQ ID NO:28 and a variable light chaincomprising the amino acid sequence of SEQ ID NO:30 has an IgG1 constantheavy chain region. Preferably, such antibody has an Igλ constant lightchain region. Preferably, such antibody is the antibody designated60833, which has a heavy chain constant region which comprises the aminoacid sequence of SEQ ID NO:32 and a light chain constant region whichcomprises the amino acid sequence of SEQ ID NO:34. The complete aminoacid sequences of the antibody designated 60833 are depicted in SEQ IDNO:39 (heavy chain) and SEQ ID NO:40 (light chain).

The cross-reactivity of the antibodies of the invention with mouse andrat IGF-1 allows to examine their endocrine effects, e.g. the effect onthe growth hormone pathway, in these species. Cross-reactivity with therat IGFs is particularly advantageous because the rat is an excellentanimal model that is preferably used in drug development to studytoxicological effects.

The observed pharmacodynamic effect of the antibodies on total IGF-1levels, likely due to removal of the free IGF-1, which results infeedback regulation through the growth hormone pathway resulting inincreased secretion of IGF-1 by the liver, is a useful pharmacodynamicmarker. The availability of such marker in animal species, which allowsdetermination of a dose/effect relationship early in drug development,facilitates the preparation of Phase I clinical studies where, inaddition to PK analysis, the pharmacodynamic response on total IGF-1levels in patients are monitored.

The anti-IGF antibody molecule of the invention may also be a variant ofan antibody as defined by the amino acid sequences shown in the sequencelisting. Thus, the invention also embodies antibodies that are variantsof these polypeptides, which have the features a) to c) defined above.Using routinely available technologies, the person skilled in the artwill be able to prepare, test and utilize functional variants of theantibodies 60814, 60819 and 60833. Examples are variant antibodies withat least one position in a CDR and/or framework altered, variantantibodies with single amino acid substitutions in the framework regionwhere there is a deviation from the germline sequence, antibodies withconservative amino substitutions, antibodies that are encoded by DNAmolecules that hybridize, under stringent conditions, with the DNAmolecules presented in the sequence listing encoding antibody variablechains of 60814, 60819 or 60833, functionally equivalent codon-optimizedvariants of 60814, 60819 and 60833.

A variant may also be obtained by using an antibody of the invention asstarting point for optimization and diversifying one or more amino acidresidues, preferably amino acid residues in one or more CDRs, and byscreening the resulting collection of antibody variants for variantswith improved properties. Particularly preferred is diversification ofone or more amino acid residues in CDR3 of the variable light chain,CDR3 of the variable heavy chain, CDR1 of the variable light and/or CDR2of the variable heavy chain. Diversification can be done by methodsknown in the art, e.g. the so-called TRIM technology referred to in WO2007/042309.

Given the properties of individual amino acids, rational substitutionscan be performed to obtain antibody variants that conserve the overallmolecular structure of antibody 60814, 60819 or 60833. Amino acidsubstitutions, i.e., “conservative substitutions”, may be made, forinstance, on the basis of similarity in polarity, charge, solubility,hydrophobicity, hydrophilicity, and/or the amphipathic nature of therespective amino acid. The skilled person is familiar with commonlypracticed amino acid substitutions, as described e.g. in WO 2007/042309,and methods for obtaining thus modified antibodies. Given the geneticcode and recombinant and synthetic DNA techniques, DNA moleculesencoding variant antibodies with one or more conservative amino acidexchanges can be routinely designed and the respective antibodiesreadily obtained.

Preferred antibody variants have a sequence identity in the variableregions of at least 60%, more preferably, at least 70% or 80%, stillmore preferably at least 90% and most preferably at least 95%. Preferredantibodies also have a sequence similarity in the variable regions of atleast 80%, more preferably 90% and most preferably 95%.

(“Sequence identity” between two polypeptide sequences indicates thepercentage of amino acids that are identical between the sequences.“Sequence similarity” indicates the percentage of amino acids thateither are identical or that represent conservative amino acidsubstitutions.)

In a further embodiment, the anti-IGF antibody molecule of the inventionis an “affinity matured” antibody.

An “affinity matured” anti-IGF antibody is an anti-IGF antibody derivedfrom a parent anti-IGF antibody, e.g. 60814, 60819 or 60833, that hasone or more alterations in one or more CDRs or in which one or morecomplete CDRs have been replaced, which results in an improvement in theaffinity for the antigens, compared to the respective parent antibody.One of the procedures for generating such antibody mutants involvesphage display (Hawkins et al., 1992; and Lowman et al., 1991). Briefly,several hypervariable region sites (e.g. 6-7 sites) are mutated togenerate all possible amino substitutions at each site. The antibodymutants thus generated are displayed in a monovalent fashion fromfilamentous phage particles as fusions to the gene III product of M13packaged within each particle. The phage-displayed mutants are thenscreened for their biological activity (e.g. binding affinity) as hereindisclosed.

Affinity matured antibodies may also be produced by methods asdescribed, for example, by Marks et al., 1992, (affinity maturation byvariable heavy chain (VH) and variable light chain (VL) domainshuffling), or Barbas et al., 1994; Shier et al., 1995; Yelton et al.,1995; Jackson et al., 1995; and Hawkins et al., 1992, (randommutagenesis of CDR and/or framework residues). Preferred affinitymatured antibodies will have very high affinities, e.g. low picomolar,for the target antigen.

The present invention also relates to DNA molecules that encode ananti-IGF antibody molecule of the invention. These sequences include,but are not limited to, those DNA molecules encoding antibodies 60814,60819 and 60833 as shown in the sequence listing: SEQ ID NO:7 and SEQ IDNO:9, respectively, encoding the variable heavy and light chain,respectively, of antibody 60814; SEQ ID NO:17 and SEQ ID NO:19, encodingthe variable heavy and light chain, respectively, of antibody 60819; SEQID NO:27 and SEQ ID NO:29, encoding the variable heavy and light chain,respectively, of antibody 60833.

The sequences shown in SEQ ID NO:9, SEQ ID NO:19 and 29, encoding thevariable light chains, may, at their 3′ end, contain an additional codonfor Gln.

Accordingly, the present invention also relates to nucleic acidmolecules that hybridize to the DNA molecules set forth in the sequencelisting under high stringency binding and washing conditions, as definedin WO 2007/042309, where such nucleic molecules encode an antibody orfunctional fragment thereof that has properties equivalent or superiorto antibody 60814, 60819 or 60833. Preferred molecules (from an mRNAperspective) are those that have at least 75% or 80% (preferably atleast 85%, more preferably at least 90% and most preferably at least95%) homology or sequence identity with one of the DNA moleculesdescribed herein.

Yet another class of DNA variants that are within the scope of theinvention may be defined with reference to the polypeptide they encode.These DNA molecules deviate with respect to their sequence from thosedepicted in the sequence listing (SEQ ID NOs:7, 17 and 27, or 9, 19, 29,respectively), but encode, due to the degeneracy of the genetic code,antibodies with the identical amino acid sequences of antibodies 60814,60819 or 60833, respectively. By way of example, in view of expressingantibodies 60814, 60819 or 60833 in eukaryotic cells, the last ninenucleotides, respectively, that encode the last three amino acids of thevariable light chains, can be designed to match codon usage ineukaryotic cells. If it is desired to express the antibodies in E. coli,these sequences can be changed to match E. coli codon usage.

Variants of DNA molecules of the invention can be constructed in severaldifferent ways, as described in WO 2007/042309.

For producing the recombinant anti-IGF antibody molecules of theinvention, the DNA molecules (cDNA and/or genomic DNA) encodingfull-length light chain (in the case of antibody 60814, a sequencecomprising SEQ ID NO:9 and SEQ ID NO:33) and heavy chain (in the case ofantibody 60814, the sequence comprising SEQ ID NO:7 and SEQ ID NO:31),or fragments thereof, are inserted into expression vectors such that thesequences are operatively linked to transcriptional and/or translationalcontrol sequences. In the case of antibody 60819, the sequences arethose of SEQ ID NO:19 and SEQ ID NO:33, and SEQ ID NO:17 and SEQ IDNO:31, respectively, in the case of antibody 60833, the sequences arethose of SEQ ID NO:29 and SEQ ID NO:33, and SEQ ID NO:27 and SEQ IDNO:31, respectively.

For manufacturing the antibodies of the invention, the skilled artisanmay choose from a great variety of expression systems well known in theart, e.g. those reviewed by Kipriyanow and Le Gall, 2004.

In another aspect, the present invention relates to an expression vectorcontaining a DNA molecule comprising the nucleotide sequence encodingthe variable heavy chain and/or the variable light chain of an antibodymolecule as described above. Preferably, such an expression vector ofcontaining a DNA molecule comprising the nucleotide sequence of SEQ IDNO:7 and/or SEQ ID NO:9, or comprising the sequence of SEQ ID NO:17and/or SEQ ID NO:19, or comprising the sequence of SEQ ID NO:27 and/orSEQ ID NO:29. Preferably, such an expression vector additionallycomprises a DNA molecule encoding the constant heavy chain and/or theconstant light chain, respectively, linked to the DNA molecule encodingthe variable heavy chain and/or the variable light chain, respectively.

Expression vectors include plasmids, retroviruses, cosmids, EBV derivedepisomes, and the like. The expression vector and expression controlsequences are selected to be compatible with the host cell. The antibodylight chain gene and the antibody heavy chain gene can be inserted intoseparate vectors. In certain embodiments, both DNA sequences areinserted into the same expression vector.

Convenient vectors are those that encode a functionally complete humanCH (constant heavy) or CL (constant light) immunoglobulin sequence, withappropriate restriction sites engineered so that any VH (variable heavy)or VL (variable light) sequence can be easily inserted and expressed, asdescribed above. In the case of the antibodies with the variable regionsof 60814, 60819 and 60833, the constant chain is usually kappa or lambdafor the antibody light chain, for the antibody heavy chain, it can be,without limitation, any IgG isotype (IgG1, IgG2, IgG3, IgG4) or otherimmunoglobulins, including allelic variants.

The recombinant expression vector may also encode a signal peptide thatfacilitates secretion of the antibody chain from a host cell. The DNAencoding the antibody chain may be cloned into the vector such that thesignal peptide is linked in-frame to the amino terminus of the matureantibody chain DNA. The signal peptide may be an immunoglobulin signalpeptide or a heterologous peptide from a non-immunoglobulin protein.Alternatively, the DNA sequence encoding the antibody chain may alreadycontain a signal peptide sequence.

In addition to the antibody chain DNA sequences, the recombinantexpression vectors carry regulatory sequences including promoters,enhancers, termination and polyadenylation signals and other expressioncontrol elements that control the expression of the antibody chains in ahost cell. Examples for promoter sequences (exemplified for expressionin mammalian cells) are promoters and/or enhancers derived from CMV(such as the CMV Simian Virus 40 (SV40) promoter/enhancer), adenovirus,(e.g., the adenovirus major late promoter (AdMLP)), polyoma and strongmammalian promoters such as native immunoglobulin and actin promoters.Examples for polyadenylation signals are BGH polyA, SV40 late or earlypolyA; alternatively, 3′UTRs of immunoglobulin genes etc. can be used.

The recombinant expression vectors may also carry sequences thatregulate replication of the vector in host cells (e.g. origins ofreplication) and selectable marker genes. Nucleic acid moleculesencoding the heavy chain or an antigen-binding portion thereof and/orthe light chain or an antigen-binding portion thereof of an anti-IGFantibody, and vectors comprising these DNA molecules can be introducedinto host cells, e.g. bacterial cells or higher eukaryotic cells, e.g.mammalian cells, according to transfection methods well known in theart, including liposome-mediated transfection, polycation-mediatedtransfection, protoplast fusion, microinjections, calcium phosphateprecipitation, electroporation or transfer by viral vectors.

Preferably, the DNA molecules encoding the heavy chain and the lightchain are present on two vectors which are co-transfected into the hostcell, preferably a mammalian cell.

In a further aspect, the present invention relates to a host cellcarrying one or more expression vectors as described before, preferablya mammalian cell.

Mammalian cell lines available as hosts for expression are well known inthe art and include, inter alia, Chinese hamster ovary (CHO) cells, NSO,SP2/0 cells, HeLa cells, baby hamster kidney (BHK) cells, monkey kidneycells (COS), human carcinoma cells (e.g., Hep G2 and A-549 cells), 3T3cells or the derivatives/progenies of any such cell line. Othermammalian cells, including but not limited to human, mice, rat, monkeyand rodent cells lines, or other eukaryotic cells, including but notlimited to yeast, insect and plant cells, or prokaryotic cells such asbacteria may be used. The anti-IGF antibody molecules of the inventionare produced by culturing the host cells for a period of time sufficientto allow for expression of the antibody molecule in the host cells.

Thus, in a further aspect, the present invention relates to a method forproducing an antibody molecule as described, comprising transfecting amammalian host cell with one or more vectors as described, cultivatingthe host cell and recovering and purifying the antibody. In anotherembodiment, the present invention relates to a method for producing anantibody as described above, comprising obtaining a mammalian host cellcomprising one or more vectors as described, and cultivating the hostcell. In another embodiment, the method further comprises recovering andpurifying the antibody.

Antibody molecules are preferably recovered from the culture medium as asecreted polypeptide or it can be recovered from host cell lysates iffor example expressed without a secretory signal. It is necessary topurify the antibody molecules using standard protein purificationmethods used for recombinant proteins and host cell proteins in a waythat substantially homogenous preparations of the antibody are obtained.By way of example, state-of-the art purification methods useful forobtaining the anti-IGF antibody molecule of the invention include, as afirst step, removal of cells and/or particulate cell debris from theculture medium or lysate. The antibody is then purified from contaminantsoluble proteins, polypeptides and nucleic acids, for example, byfractionation on immunoaffinity or ion-exchange columns, ethanolprecipitation, reverse phase HPLC, Sephadex chromatography,chromatography on silica or on a cation exchange resin. As a final stepin the process for obtaining an anti-IGF antibody molecule preparation,the purified antibody molecule may be dried, e.g. lyophilized, asdescribed below for therapeutic applications.

In one embodiment, the anti-IGF antibody molecule of the invention maybe purified by a sequence of state-of-the art purifications stepscomprising affinity chromatography (recombinant Protein A), low pH viralinactivation, depth filtration, cation exchange chromatography, anionexchange chromatography, nanofiltration, and 30 kD ultra/diafiltration(Shukla et al., 2007).

In a further aspect, the present invention relates to an antibodymolecule as described above for use in medicine.

In a further aspect, the present invention relates to a pharmaceuticalcomposition containing, as the active ingredient, an anti-IGF antibodymolecule, preferably a full antibody, of the invention.

To be used in therapy, the anti-IGF antibody molecule is included intopharmaceutical compositions appropriate to facilitate administration toanimals or humans. Typical formulations of the anti-IGF antibodymolecule can be prepared by mixing the anti-IGF antibody molecule withphysiologically acceptable carriers, excipients or stabilizers, in theform of lyophilized or otherwise dried formulations or aqueous solutionsor aqueous or non-aqueous suspensions. Carriers, excipients, modifiersor stabilizers are nontoxic at the dosages and concentrations employed.They include buffer systems such as phosphate, citrate, acetate andother anorganic or organic acids and their salts; antioxidants includingascorbic acid and methionine; preservatives such asoctadecyldimethylbenzyl ammonium chloride; hexamethonium chloride;benzalkonium chloride, benzethonium chloride; phenol, butyl or benzylalcohol; alkyl parabens such as methyl or propyl paraben; catechol;resorcinol; cyclohexanol; 3-pentanol; and m-cresol); proteins, such asserum albumin, gelatin, or immunoglobulins; hydrophilic polymers such aspolyvinylpyrrolidone or polyethylene glycol (PEG); amino acids such asglycine, glutamine, asparagine, histidine, arginine, or lysine;monosaccharides, disaccharides, oligosaccharides or polysaccharides andother carbohydrates including glucose, mannose, sucrose, trehalose,dextrins or dextrans; chelating agents such as EDTA; sugar alcohols suchas, mannitol or sorbitol; salt-forming counter-ions such as sodium;metal complexes (e.g., Zn-protein complexes); and/or ionic or non-ionicsurfactants such as TWEEN™ (polysorbates), PLURONICS™ or fatty acidesters, fatty acid ethers or sugar esters. Also organic solvents can becontained in the antibody formulation such as ethanol or isopropanol.The excipients may also have a release-modifying or absorption-modifyingfunction.

The anti-IGF antibody molecules may also be dried (freeze-dried,spray-dried, spray-freeze dried, dried by near or supercritical gases,vacuum dried, air-dried), precipitated or crystallized or entrapped inmicrocapsules that are prepared, for example, by coacervation techniquesor by interfacial polymerization using, for example,hydroxymethylcellulose or gelatin and poly-(methylmethacylate),respectively, in colloidal drug delivery systems (for example,liposomes, albumin microspheres, microemulsions, nano-particles andnanocapsules), in macroemulsions or precipitated or immobilized ontocarriers or surfaces, for example by pcmc technology (protein coatedmicrocrystals). Such techniques are disclosed in Remington, 2005.

Naturally, the formulations to be used for in vivo administration mustbe sterile; sterilization may be accomplished be conventionaltechniques, e.g. by filtration through sterile filtration membranes.

It may be useful to increase the concentration of the anti-IGF antibodyto come to a so-called high concentration liquid formulation (HCLF);various ways to generate such HCLFs have been described.

The anti-IGF antibody molecule may also be contained in asustained-release preparation. Such preparations include solid,semi-solid or liquid matrices of hydrophobic or hydrophilic polymers,and may be in the form of shaped articles, e.g., films, sticks ormicrocapsules and may be applied via an application device. Examples ofsustained-release matrices include polyesters, hydrogels (for example,poly(2-hydroxyethyl-methacrylate or sucrose acetate butyrate), orpoly(vinylalcohol)), polylactides (U.S. Pat. No. 3,773,919), copolymersof L-glutamic acid and γ ethyl-L-glutamate, non-degradableethylene-vinyl acetate, degradable lactic acid-glycolic acid copolymerssuch as the LUPRON DEPOT™ (injectable microspheres composed of lacticacid-glycolic acid copolymer and leuprolide acetate), andpoly-D-(−)-3-hydroxybutyric acid. While polymers such as ethylene-vinylacetate and lactic acid-glycolic acid enable release of molecules forover 100 days, certain hydrogels release proteins for shorter timeperiods. When encapsulated antibodies remain in the body for a longtime, they may denature or aggregate as a result of exposure to moistureat 37° C., resulting in a loss of biological activity and possiblechanges in immunogenicity. Rational strategies can be devised forstabilization depending on the mechanism involved. For example, if theaggregation mechanism is discovered to be intermolecular S—S bondformation through thio-disulfide interchange, stabilization may beachieved by modifying sulfhydryl residues, lyophilization (e.g. asdescribed in WO 89/011297) from acidic solutions, controlling moisturecontent, using appropriate additives, and developing specific polymermatrix compositions.

Formulations that may also be used for the anti-IGF antibody molecule ofthe invention are described in U.S. Pat. No. 7,060,268 and U.S. Pat. No.6,991,790.

The IGF antibody molecule can be incorporated also in other applicationforms, such as dispersions, suspensions or liposomes, tablets, capsules,powders, sprays, transdermal or intradermal patches or creams with orwithout permeation enhancing devices, wafers, nasal, buccal or pulmonaryformulations, or may be produced by implanted cells or—after genetherapy—by the individual's own cells.

An anti-IGF antibody molecule may also be derivatized with a chemicalgroup such as polyethylene glycol (PEG), a methyl or ethyl group, or acarbohydrate group. These groups may be useful to improve the biologicalcharacteristics of the antibody, e.g., to increase serum half-life or toincrease tissue binding.

The preferred mode of application is parenteral, by infusion orinjection (intraveneous, intramuscular, subcutaneous, intraperitoneal,intradermal), but other modes of application such as by inhalation,transdermal, intranasal, buccal, oral, may also be applicable.

In a preferred embodiment, the pharmaceutical composition of theinvention contains the anti-IGF-antibody, e.g. antibody 60814, 60819 or60833, in a concentration of 10 mg/ml and further comprises 25 mM Nacitrate pH 6, 115 mM NaCl, 0.02% Tween® (polysorbate 20).

In another embodiment, the pharmaceutical composition of the inventionis an aqueous solution which contains the anti-IGF-antibody, e.g.antibody 60814, 60819 or 60833, in a concentration of 10 mg/ml, andfurther comprises 25 mM histidine HCl pH 6, 38.8 g/L mannitol, 9.70 g/Lsucrose, and 0.02% Tween® (polysorbate 20).

For intravenous infusion, the pharmaceutical composition of theinvention may be diluted with a physiological solution, e.g. with 0.9%sodium chloride or G5 solution.

The pharmaceutical composition may be freeze-dried and reconstitutedwith water for injection (WFI) before use.

For the prevention or treatment of disease, the appropriate dosage ofantibody will depend on the type of disease to be treated, the severityand course of the disease, whether the antibody is administered forpreventive or therapeutic purposes, previous therapy, the patient'sclinical history and response to the antibody, and the discretion of theattending physician. The antibody is suitably administered to thepatient at one time or over a series of treatments.

Depending on the type and severity of the disease, about 1 μg/kg to 20mg/kg (e.g. 0.1-15 mg/kg) of antibody is an initial candidate dosage foradministration to the patient, whether, for example, by one or moreseparate administrations, or by continuous infusion, e.g. infusion over1 hour. A typical treatment schedule usually involves administration ofthe antibody once every week to once every three weeks with dosesranging from about 0.1 μg/kg to ca. 20 mg/kg or more, depending on thefactors mentioned above. For example, a weekly dose could be 5, 10, or15 mg/kg. Progress of this therapy is easily monitored by conventionaltechniques and assays.

The “therapeutically effective amount” of the antibody to beadministered is the minimum amount necessary to prevent, ameliorate, ortreat a disease or disorder.

The anti-IGF antibody molecule of the invention and pharmaceuticalcompositions containing it are useful for the treatment ofhyperproliferative disorders.

In certain embodiments, the hyperproliferative disorder is cancer.

Cancers are classified in two ways: by the type of tissue in which thecancer originates (histological type) and by primary site, or thelocation in the body, where the cancer first developed. The most commonsites in which cancer develops include the skin, lung, breast, prostate,colon and rectum, cervix and uterus.

The anti-IGF antibody molecules of the invention are useful in thetreatment of a variety of cancers, including but not limited to thefollowing:

-   -   AIDS-related cancer such as Kaposi's sarcoma;    -   bone related cancer such as Ewing's family of tumours and        osteosarcoma;    -   brain related cancer such as adult brain tumour, childhood brain        stem glioma, childhood cerebellar astrocytoma, childhood        cerebral astrocytoma/malignant glioma, childhood ependymoma,        childhood medulloblastoma, childhood supratentorial primitive        neuroectodermal tumours, childhood visual pathway and        hypothalamic glioma and other childhood brain tumours;    -   breast cancer;    -   digestive/gastrointestinal related cancer such as anal cancer,        extrahepatic bile duct cancer, gastrointestinal carcinoid        tumour, gastrointestinal stroma tumour (GIST),        cholangiocarcinoma, colon cancer, esophageal cancer, gallbladder        cancer, adult primary liver cancer (hepatocellular carcinoma,        hepatoblastoma) childhood liver cancer, pancreatic cancer,        rectal cancer, small intestine cancer and stomach (gastric)        cancer;    -   endocrine related cancer such as adrenocortical carcinoma,        gastrointestinal carcinoid tumour, islet cell carcinoma        (endocrine pancreas), parathyroid cancer, pheochromocytoma,        pituitary tumour and thyroid cancer;    -   eye related cancer such as intraocular melanoma, and        retinoblastoma;    -   genitourinary related cancer such as bladder cancer, kidney        (renal cell) cancer, penile cancer, prostate cancer,        transitional cell renal pelvis and ureter cancer, testicular        cancer, urethral cancer, Wilms' tumour and other childhood        kidney tumours;    -   germ cell related cancer such as childhood extracranial germ        cell tumour, extragonadal germ cell tumour, ovarian germ cell        tumour and testicular cancer;    -   gynecologic cancer such as cervical cancer, endometrial cancer,        gestational trophoblastic tumour, ovarian epithelial cancer,        ovarian germ cell tumour, ovarian low malignant potential        tumour, uterine sarcoma, vaginal cancer and vulvar cancer;    -   head and neck related cancer such as hypopharyngeal cancer,        laryngeal cancer, lip and oral cavity cancer, metastatic        squamous neck cancer with occult primary, nasopharyngeal cancer,        oropharyngeal cancer, paranasal sinus and nasal cavity cancer,        parathyroid cancer and salivary gland cancer;    -   hematologic/blood related cancer such as leukemias, such as        adult acute lymphoblastic leukemia, childhood acute        lymphoblastic leukemia, adult acute myeloid leukemia, childhood        acute myeloid leukemia, chronic lymphocytic leukemia, chronic        myelogenous leukemia and hairy cell leukemia; and lymphomas,        such as AIDS-related lymphoma, cutaneous T-cell lymphoma, adult        Hodgkin's lymphoma, childhood Hodgkin's lymphoma, Hodgkin's        lymphoma during pregnancy, mycosis fungoides, adult        non-Hodgkin's lymphoma, childhood non-Hodgkin's lymphoma,        non-Hodgkin's lymphoma during pregnancy, primary central nervous        system lymphoma, Sezary syndrome, cutaneous T-cell lymphoma and        Waldenstrom's macroglobulinemia and other hematologic/blood        related cancer such as chronic myeloproliferative disorders,        multiple myeloma/plasma cell neoplasm, myelodysplastic syndromes        and myelodysplastic/myeloproliferative diseases;    -   musculoskeletal related cancer such as Ewing's family of        tumours, osteosarcoma, malignant fibrous histiocytoma of bone,        childhood rhabdomyosarcoma, adult soft tissue sarcoma, childhood        soft tissue sarcoma and uterine sarcoma; hemangiosarcomas and        angiosarcoma;    -   neurologicrelated cancer such as adult brain tumour, childhood        brain tumour, brain stem glioma, cerebellar astrocytoma,        cerebral astrocytoma/malignant glioma, ependmoma,        medulloblastoma, supratentorial primitive neuroectodermal        tumours, visual pathway and hypothalamic glioma and other brain        tumours such as neuroblastoma, pituitary tumour and primary        central nervous system lymphoma;    -   respiratory/thoracic related cancer such as non-small cell lung        cancer, small cell lung cancer, malignant mesothelioma, thymoma        and thymic carcinoma;    -   skin related cancer such as cutaneous T-cell lymphoma, Kaposi's        sarcoma, melanoma, Merkel cell carcinoma and skin cancer;    -   Small blue round cell tumours.

In particular, the anti-IGF antibody molecules of the invention andpharmaceutical compositions containing them are beneficial in thetreatment of cancers of the hematopoietic system including leukemias,lymphomas and myelomas, cancers of the gastrointestinal tract includingesophageal, gastric, colorectal, pancreatic, liver and gall bladder andbile duct cancer; kidney, prostate and bladder cancer; gynecologicalcancers including breast, ovarian, cervical and endometrial cancer; skinand head and neck cancers including malignant melanomas; pediatriccancers like Wilms' tumour, neuroblastoma and Ewing' sarcoma; braincancers like glioblastoma; sarcomas like osteosarcoma, soft tissuesarcoma, rhabdomyosarcoma, hemangiosarcoma; lung cancer, mesotheliomaand thyroid cancer.

In a preferred aspect of the invention, the anti-IGF antibody moleculesof the invention and pharmaceutical compositions containing them arebeneficial in the treatment of non-small cell lung cancer (NSCLC), inparticular locally advanced or metastatic NSCLC (stage IIIB/IV). In thiscontext, the anti-IGF antibody molecules of the invention can becombined with platinum-based chemotherapy, in particularpaclitaxel/carboplatin or gemcitabine/cisplatin platinum doublettherapy.

In a further preferred aspect of the invention, the anti-IGF antibodymolecules of the invention and pharmaceutical compositions containingthem are beneficial in the treatment of hepatocellular carcinoma, inparticular locally advanced or hepatocellular carcinoma (stage III/IV).In this context, the anti-IGF antibody molecules of the invention can becombined with sorafenib (Strumberg D., 2005).

In another embodiment, the anti-IGF antibody molecules andpharmaceutical compositions containing them are useful for non-canceroushyperproliferative disorders such as, without limitation, psoriasis andrestenosis after angioplasty. In addition, based on the recentobservation (Reinberg, 2008) that a gene mutation that decreases theactivity of IGF-1 has a positive effect on longevity, the antibodies ofthe invention have the potential to be useful, when applied to adults,in therapies to slow aging and prevent age-related diseases.

Thus, in a further aspect, the present invention relates to the use ofan antibody molecule as described above for the preparation of amedicament for the treatment of a cancerous disease outlined above.

In another aspect, the present invention relates to a pharmaceuticalcomposition as described above for the treatment of a cancerous diseaseas outlined before.

In another aspect, the present invention relates to a method fortreating a patient suffering from a cancerous disease as outlined above,comprising administering to said patient an effective amount of apharmaceutical composition as described herein.

Depending on the disorder to be treated, the anti-IGF antibody moleculeof the invention may be used on its own or in combination with one ormore additional therapeutic agents, in particular selected from DNAdamaging agents or therapeutically active compounds that inhibitangiogenesis, signal transduction pathways or mitotic checkpoints incancer cells.

The additional therapeutic agent may be administered simultaneouslywith, optionally as a component of the same pharmaceutical preparation,or before or after administration of the anti-IGF antibody molecule.

In certain embodiments, the additional therapeutic agent may be, withoutlimitation, one or more inhibitors selected from the group of inhibitorsof EGFR, VEGFR, HER2-neu, AuroraA, AuroraB, PLK and PI3 kinase, FGFR,PDGFR, Raf, KSP or PDK1.

Further examples of additional therapeutic agents are inhibitors of CDK,Akt, src/bcr-abl, cKit, cMet/HGF, c-Myc, Flt3, HSP90, hedgehogantagonists, inhibitors of JAK/STAT, Mek, mTor, NFkappaB, theproteasome, Rho, an inhibitor of wnt signaling or an ubiquitinationpathway inhibitor.

Examples for Aurora inhibitors are, without limitation, PHA-739358,AZD-1152, AT-9283, CYC-116, R-763, VX-667, MLN-8045, PF-3814735,SNS-314, VX-689, GSK-1070916, TTP-607, PHA-680626, MLN-8237 andENMD-2076.

An example for a PLK inhibitor is GSK-461364.

Examples for raf inhibitors are BAY-73-4506 (also a VEGFR inhibitor),PLX-4032, RAF-265 (also a VEGFR inhibitor), sorafenib (also a VEGFRinhibitor), XL-281, and Nevavar (also an inhibitor of the VEGFR).

Examples for KSP inhibitors are ispinesib, ARRY-520, AZD-4877,CK-1122697, GSK-246053A, GSK-923295, MK-0731, SB-743921, LY-2523355, andEMD-534085.

Examples for a src and/or bcr-abl inhibitors are dasatinib, AZD-0530,bosutinib, XL-228 (also an IGF-1R inhibitor), nilotinib (also a PDGFRand cKit inhibitor), imatinib (also a cKit inhibitor), NS-187, KX2-391,AP-24534 (also an inhibitor of EGFR, FGFR, Tie2, Flt3), KM-80 and LS-104(also an inhibitor of Flt3, Jak2).

An example for a PDK1 inhibitor is AR-12.

An example for a Rho inhibitor is BA-210.

Examples for PI3 kinase inhibitors are PX-866, PX-867, BEZ-235 (also anmTor inhibitor), XL-147, XL-765 (also an mTor inhibitor), BGT-226,CDC-0941, GSK-1059615.

Examples for inhibitors of cMet or HGF are XL-184 (also an inhibitor ofVEGFR, cKit, Flt3), PF-2341066, MK-2461, XL-880 (also an inhibitor ofVEGFR), MGCD-265 (also an inhibitor of VEGFR, Ron, Tie2), SU-11274,PHA-665752, AMG-102, AV-299, ARQ-197, MetMAb, CGEN-241, BMS-777607,JNJ-38877605, PF-4217903, SGX-126, CEP-17940, AMG-458, INCB-028060, andE-7050.

An example for a c-Myc inhibitor is CX-3543.

Examples for Flt3 inhibitors are AC-220 (also an inhibitor of cKit andPDGFR), KW-2449, LS-104 (also an inhibitor of bcr-abl and Jak2),MC-2002, SB-1317, lestaurtinib (also an inhibitor of VEGFR, PDGFR, PKC),TG-101348 (also an inhibitor of JAK2), XL-999 (also an inhibitor ofcKit, FGFR, PDGFR and VEGFR), sunitinib (also an inhibitor of PDGFR,VEGFR and cKit), and tandutinib (also an inhibitor of PDGFR, and cKit).

Examples for HSP90 inhibitors are, tanespimycin, alvespimycin, IPI-504,STA-9090, MEDI-561, AUY-922, CNF-2024, and SNX-5422.

Examples for JAK/STAT inhibitors are CYT-997 (also interacting withtubulin), TG-101348 (also an inhibitor of Flt3), and XL-019.

Examples for Mek inhibitors are ARRY-142886, AS-703026, PD-325901,AZD-8330, ARRY-704, RDEA-119, and XL-518.

Examples for mTor inhibitors are rapamycin, temsirolimus, deforolimus(which also acts as a VEGF inhibitor), everolimus (a VEGF inhibitor inaddition), XL-765 (also a PI3 kinase inhibitor), and BEZ-235 (also a PI3kinase inhibitor).

Examples for Akt inhibitors are perifosine, GSK-690693, RX-0201, andtriciribine.

Examples for cKit inhibitors are masitinib, OSI-930 (also acts as aVEGFR inhibitor), AC-220 (also an inhibitor of Flt3 and PDGFR),tandutinib (also an inhibitor of Flt3 and PDGFR), axitinib (also aninhibitor of VEGFR and PDGFR), sunitinib (also an inhibitor of Flt3,PDGFR, VEGFR), and XL-820 (also acts as a VEGFR- and PDGFR inhibitor),imatinib (also a bcr-abl inhibitor), nilotinib (also an inhibitor ofbcr-abl and PDGFR).

Examples for hedgehog antagonists are IPI-609, CUR-61414, GDC-0449,IPI-926, and XL-139.

Examples for CDK inhibitors are seliciclib, AT-7519, P-276, ZK-CDK (alsoinhibiting VEGFR2 and PDGFR), PD-332991, R-547, SNS-032, PHA-690509,PHA-848125, and SCH-727965.

Examples for proteasome inhibitors/NFkappaB pathway inhibitors arebortezomib, carfilzomib, NPI-0052, CEP-18770, MLN-2238, PR-047, PR-957,AVE-8680, and SPC-839.

An example for an ubiquitination pathway inhibitor is HBX-41108.

Examples for anti-angiogenic agents are inhibitors of the FGFR, PDGFRand VEGF(R), and thalidomides, such agents being selected from, withoutlimitation, BIBF 1120 (Vargatef®), bevacizumab, motesanib, CDP-791,SU-14813, telatinib, KRN-951, ZK-CDK (also an inhibitor of CDK),ABT-869, BMS-690514, RAF-265, IMC-KDR, IMC-18F1, IMiDs, thalidomide,CC-4047, lenalidomide, ENMD-0995, IMC-D11, Ki-23057, brivanib,cediranib, 1B3, CP-868596, IMC-3G3, R-1530 (also an inhibitor of Flt3),sunitinib (also an inhibitor of cKit and Flt3), axitinib (also aninhibitor of cKit), lestaurtinib (also an inhibitor of Flt3 and PKC),vatalanib, tandutinib (also an inhibitor of Flt3 and cKit), pazopanib,PF-337210, aflibercept, E-7080, CHIR-258, sorafenib tosylate (also aninhibitor of Raf), vandetanib, CP-547632, OSI-930, AEE-788 (also aninhibitor of EGFR and Her2), BAY-57-9352 (also an inhibitor of Raf),BAY-73-4506 (also an inhibitor of Raf), XL-880 (also an inhibitor ofcMet), XL-647 (also an inhibitor of EGFR and EphB4), XL-820 (also aninhibitor of cKit), nilotinib (also an inhibitor of cKit and brc-abl),CYT-116, PTC-299, BMS-584622, CEP-11981, dovitinib, CY-2401401, andENMD-2976.

The additional therapeutic agent may also be selected from EGFRinhibitors, it may be a small molecule EGFR inhibitor or an anti-EGFRantibody. Examples for anti-EGFR antibodies, without limitation, arecetuximab, panitumumab, nimotuzumab, zalutumumab; examples for smallmolecule EGFR inhibitors are gefitinib, erlotinib and vandetanib (alsoan inhibitor of the VEGFR). Another example for an EGFR modulator is theEGF fusion toxin.

Further EGFR and/or Her2 inhibitors useful for combination with ananti-IGF antibody molecule of the invention are BIBW 2992 (Tovok®),lapatinib, trastuzumab, pertuzumab, XL-647, neratinib, BMS-599626ARRY-334543, AV-412, mAB-806, BMS-690514, JNJ-26483327, AEE-788 (also aninhibitor of VEGFR), AZD-8931, ARRY-380 ARRY-333786, IMC-11F8, Zemab,TAK-285, AZD-4769.

Other agents that may be advantageously combined in a therapy with theanti-IGF antibody molecule of the invention are tositumumab andibritumomab tiuxetan (two radiolabelled anti-CD20 antibodies);ofatumumab, rituximab, LY-2469298, ocrelizumab, TRU-015, PRO-131921,FBT-A05, veltuzumab, R-7159 (CD20 inhibitors), alemtuzumab (an anti-CD52antibody), denosumab, (an osteoclast differentiation factor ligandinhibitor), galiximab (a CD80 antagonist), zanolimumab (a CD4antagonist), SGN40 (a CD40 ligand receptor modulator), XmAb-5485, ChiLob 7/4, lucatumumab, CP-870893 (CD40 inhibitors), CAT-8015,epratuzumab, Y90-epratuzumab, inotuzumab ozogamicin (CD22 inhibitors),lumiliximab (a CD23 inhibitor), TRU-016 (a CD37 inhibitor), MDX-1342,SAR-3419, MT-103 (CD19 inhibitors), or mapatumumab, tigatuzumab,lexatumumab, Apomab, AMG-951 and AMG-655 (TRAIL receptor modulators).

Other chemotherapeutic drugs that may be used in combination with theanti-IGF antibody molecules of the present invention are selected from,but not limited to hormones, hormonal analogues and antihormonals (e.g.tamoxifen, toremifene, raloxifene, fulvestrant, megestrol acetate,flutamide, nilutamide, bicalutamide, cyproterone acetate, finasteride,buserelin acetate, fludrocortinsone, fluoxymesterone,medroxyprogesterone, octreotide, arzoxifene, pasireotide, vapreotide),aromatase inhibitors (e.g. anastrozole, letrozole, liarozole,exemestane, atamestane, formestane), LHRH agonists and antagonists (e.g.goserelin acetate, leuprolide, abarelix, cetrorelix, deslorelin,histrelin, triptorelin), antimetabolites (e.g. antifolates likemethotrexate, pemetrexed, pyrimidine analogues like 5-fluorouracil,capecitabine, decitabine, nelarabine, and gemcitabine, purine andadenosine analogues such as mercaptopurine thioguanine, cladribine andpentostatin, cytarabine, fludarabine); antitumour antibiotics (e.g.anthracyclines like doxorubicin, daunorubicin, epirubicin andidarubicin, mitomycin-C, bleomycin dactinomycin, plicamycin,mitoxantrone, pixantrone, streptozocin); platinum derivatives (e.g.cisplatin, oxaliplatin, carboplatin, lobaplatin, satraplatin);alkylating agents (e.g. estramustine, meclorethamine, melphalan,chlorambucil, busulphan, dacarbazine, cyclophosphamide, ifosfamide,hydroxyurea, temozolomide, nitrosoureas such as carmustine andlomustine, thiotepa); antimitotic agents (e.g. vinca alkaloids likevinblastine, vindesine, vinorelbine, vinflunine and vincristine; andtaxanes like paclitaxel, docetaxel and their formulations, larotaxel;simotaxel, and epothilones like ixabepilone, patupilone, ZK-EPO);topoisomerase inhibitors (e.g. epipodophyllotoxins like etoposide andetopophos, teniposide, amsacrine, topotecan, irinotecan) andmiscellaneous chemotherapeutics such as amifostine, anagrelide,interferone alpha, procarbazine, mitotane, and porfimer, bexarotene,celecoxib.

In one aspect, the anti-IGF antibody molecules of the invention are usedin combination with platinum-based chemotherapy, for example incombination with paclitaxel/carboplatin or gemcitabine/cisplatinplatinum doublet therapy. In one embodiment, such combination therapymay be repeated several times, for examples 6 cycles (q3 weeks). Thistreatment may be followed by further repeated treatment (e.g. 6 cyclesq3 weeks) with anti-IGF antibody molecule alone. This regimen can beused e.g. in the treatment of NSCLC. In another aspect, the anti-IGFantibody molecules of the invention are used in combination withsorafenib. In one embodiment, the anti-IGF antibody molecule may beadministered repeatedly in intervals of 1-3 weeks, e.g. for 12 cycles,in combination with continuous administration of sorafenib. This regimencan be used e.g. in the treatment of hepatocellular carcinoma.

The anti-IGF antibody molecules of the invention, e.g. when used atlower concentrations, may also be combined with agents that target theIGF-1R. Such agents include antibodies that bind to IGF-1R (e.g.CP-751871, AMG-479, IMC-A12, MK-0646, AVE-1642, R-1507, BIIB-022,SCH-717454, rhu Mab IGFR and novel chemical entities that target thekinase domain of the IGF1-R (e.g. OSI-906 or BMS-554417, XL-228,BMS-754807).

The anti-IGF antibody molecules of the invention may also be used incombination with other therapies including surgery, radiotherapy,endocrine therapy, biologic response modifiers, hyperthermia andcryotherapy and agents to attenuate any adverse effect, e.g. antiemeticsand, in a preferred embodiment, antidiabetics, e.g. metformin

The anti-IGF antibody molecules of the invention are also useful indiagnosis of cancers where elevated serum levels of IGF-1 and/or IGF-2correlate with development or progression of disease, e.g. fordetermining elevated IGF-2 levels due to loss of imprinting (LOI), anepigenetic alteration affecting the insulin-like growth factor II gene(IGF2). In certain embodiments, an antibody for diagnostic applications,e.g. for detection of IGF-1 in human tissue sections byimmunohistological staining, is a chimeric antibody that is derived froma human antibody. In such antibody, the constant regions, or partsthereof, have been replaced by the respective sequences from an antibodyof another species, e.g. mouse. By using such chimeric antibody as aprimary antibody, the secondary antibody, e.g. a goat antibody whichspecifically reacts with the murine Fc portion, will specificallyrecognize the murine sequences of the chimeric primary antibody and notbind to the Fc portions of the other human immunoglobulin molecules thatare present in the human tissue sample. Thus, undesired backgroundstaining is avoided.

The antibodies of the invention, by blocking IGF-1 and IGF-2 mediatedsignal transduction, may also be useful for the control of body weightand adipose tissue formation. To this end, the antibodies of theinvention are administered alone or in combination with otheranti-obesity drugs.

Materials & Methods

Selection of High Affinity Fully Human Antibodies that Bind IGF-1

Selection of specific Fab fragment clones from the human combinatorialantibody library (HuCAL Gold) (Knappik et al., 2000) that bind humanIGF-1 with low nanomolar affinity is performed essentially as describedby Rauchenberger et al., 2003, in three panning cycles. In order toidentify Fab fragments with improved affinity to human IGF-1, several ofthese ‘parental’ Fab clones are subjected to ‘in vitro affinitymaturation’ essentially as described by Nagy et al., 2002. The L-CDR3(light chain CDR3) and H-CDR2 (heavy chain CDR2) sequences of each cloneare separately diversified by substituting the parental sequence withapproximately 10⁸ L-CDR3 and H-CDR2 cassettes from HuCAL (Knappik etal., 2000). Phages are prepared from the resultant ‘maturationlibraries’ and each library is subjected to solution pannings on humanIGF-1. In order to select the highest affinity human IGF-1 binders, thesolution pannings are performed under normal and increased stringencywashing conditions according to methods known in the art, with antigenreduction, and with and without blocking by human insulin. The panningoutputs after three phage panning rounds are subcloned into a Fabexpression vector and the affinity of each Fab for human IGF-1determined by an electrochemiluminescence-based equilibrium titrationtechnology developed by BioVeris (Witney, Oxfordshire, UK) essentiallyas described by Haenel et al., 2005. The Fab clones with the best IGF-1affinities are sequenced, then converted into human IgG1 antibodies asdescribed by Krebs et al., 2001, with subnanomolar affinity to humanIGF-1 without any change in specificity compared with the parentalantibodies.

Cloning and Recombinant Expression of IgG1 Antibodies

Variable heavy chain regions (VH) and variable light chain regions (VL)are excised from the Fab expression vectors by restriction enzymedigestion and ligated into compatible restriction enzyme sites ofpcDNA3.1 based plasmids containing the human IgG1 heavy chain and humanIgλ light chain constant regions respectively. EndoFree plasmidpreparations (Qiagen) are prepared and the heavy and light chainplasmids are co-transfected into HEK293 freestyle cells (Invitrogen) ata concentration of 1 mg/L of each plasmid according to the supplier'sprotocol. After 72 hours the supernatant is harvested and the IgGconcentration determined by ELISA. Antibody is purified on a modifiedprotein A column (GE Healthcare), eluted into a citrate buffer and thendialysed to a concentration of 2.5 mg/ml in PBS. Alternatively, a CHOcell line stably integrated with the antibody expression plasmids isgenerated and used to produce the antibodies.

Surface Plasmon Resonance Analysis for Determining Affinity Constants a)Antibody Capture Method

The sensor chip is coated with approximately 1000 RU of the referenceantibody in flow cell 1 and approximately 1000 RU of a rabbit-anti-humanFc-gamma-specific antibody in flow cell 2 using the coupling reagentsfrom an amine coupling kit. A target of 1000 RU is set in the surfacepreparation wizard of the Biacore 3000 software at a flow rate of 5μl/min Running buffer used is HBS-EP. The affinity measurements are madeusing the following parameters: 20 μl/min flow (HCB running buffer:);25° C. detection temperature; Fc1, Fc2 flow paths; Fc1, Fc2 detection;anti-IGF-huMAb-capturing: 3 min of a 1 μg/ml solution; 5 minIGF-Ag-association; 5 min IGF-Ag-dissociation; regeneration: 30 secpulse with 50 mM HCl. The IGF antigens are diluted to 500, 250, 125,62.5 and 31.3 nM in running buffer (HCB) and the different antigendilutions are run singly over Fc1 and Fc2 with random order. Blank runsusing running buffer only are run in-between. A blank run curve issubtracted from each binding curve before affinity analysis. Dataevaluation is performed using the BIAevaluation software (version 4.1,Biacore, Freiburg, Germany). The dissociation and association phases ofthe kinetics are fitted separately. For the separate fit of the k_(diss)values a time-frame of the initial 200-300 seconds in the dissociationphase is used (range of steady decrease of signal). For the separate fitof the k_(ass) values, initial time frames of approx 100 seconds areused (range of steady increase of signal) and for calculation theindividual k_(diss) values are used with the 1:1 Langmuir associationmodel. The average values with the standard deviations of the kineticdata together with the corresponding dissociation (K_(D)) andassociation (K_(A)) constants are calculated.

b) IGF Coating Method

The determination of binding constants of IGF antibodies to IGF ligandswhen the sensor chip is coated with IGF ligands is essentially performedas described above except that the sensor chip is coated with 35.1pg/mm² and 38.5 pg/mm² IGF-1 and IGF-2 respectively. The antibodies arethen flowed over the chip at the following concentrations: 50, 25, 12.5,6.25, 3.12 nM.

Measurement of Binding to Human, Murine and Rat IGFs and to HumanInsulin in Immunosorbent Assays

Fully human IgG1 antibodies that bound with high affinity to IGF-1 arealso tested for binding to human IGF-1 in direct immunosorbent assays(ELISA). Assays are performed by coating human IGF-1 (R&D Systems, No.291-G1) to 96-well Maxisorb plates at a concentration of 0.5 μg/mlovernight at 4° C. (100 μl/well). Coating buffer alone is used as acontrol for unspecific binding. Wells are then washed once with washingbuffer (1×TBS-T) and residual binding sites are blocked with 200 μlblocking buffer for 1 hour at room temperature on an orbital shakerfollowed by a further wash cycle. Serial three-fold dilutions of eachtest antibody in blocking buffer are prepared directly on the coatedplates. Typical concentrations used are 50, 16.6, 5.6, 1.8, 0.6, 0.2,and 0.07 ng/ml. Blocking buffer alone is used as a positive control. Theplates are then incubated for 2 hours at room temperature withagitation. After three wash cycles 100 μl/well of HRPO-conjugatedanti-human IgG secondary reagent (Jackson ImmunoResearch Inc.) dilutedin blocking buffer is added to all wells. After 2 hours incubation atroom temperature with agitation the plates are washed three-times and100 μl/well of TMB substrate solution (equal amounts of solution A andB) are pipetted into all wells. The plates are incubated for 10-20 minat RT with agitation and then the reaction is stopped by addition of 100μl/well 1 M phosphoric acid. The absorbance is measured at a wavelengthof 450 nm (reference 650 nm).

Binding of the fully human IGF-1 binding IgG1 antibodies to mouse IGF-1(R&D Systems, No. 791-MG), rat IGF-1 (IBT, No. RU100), human IGF-2(GroPep, No. FM001), mouse IGF-2 (R&D Systems, No. 792-MG), rat IGF-2(IBT, No. AAU100), and human insulin (Roche) is also tested as describedabove for human IGF-1 (except that the concentration of human insulinused for coating is 3 μg/ml).

In Vitro Cell Proliferation Assays for Determining NeutralizationPotency

The MCF-7 breast cancer derived cell line (ATCC, HTB-22) and COLO 205colon cancer-derived cell line (ATCC # CCL-222) are plated in 96-wellplates at a cell density of 1000 cells per well in serum-free RPMImedium. 10 ng/ml of either IGF-1 or IGF-2 is added in the presence orabsence of a humanized isotype control antibody that does not bind IGF-1or IGF-2, or antibodies 60814, 60819, and 60833 at concentrations of 12,37, 111, 333, 1000 and 3000 ng/ml. Cells are cultured for 5 days thenthe relative cell number in each well determined using the CellTiter-Gloluminescent cell viability assay (Promega). Luminescence(LU=Luminescence Units) is recorded using a XFluor GENios Pro 4.

Ewing's Sarcoma-Derived Cell Line Growth Assay

The Ewing's sarcoma-derived cell lines TC-71 (ATCC # ACC516) and SK-ES-1(ATCC# HTB86) are plated in 96-well plates at a density of 1000 cellsper well in DMEM medium containing 1×NEAA, 1× sodium pyruvate, 1×glutamax and 10% fetal calf serum (FCS) and incubated overnight at 37°C. and 5% CO₂ in a humidified atmosphere. The following day a serialdilution of test antibody, humanized isotype control antibody (ahumanized IgG1 antibody targeted to CD44-v6) that does not bind IGF-1 orIGF-2, rapamycin, or a combination of rapamycin and test antibody, areadded to the cells. The typical concentrations used are 30, 10, 3.3,1.1, 0.37, and 0.12 μg/ml (or 100, 10, 1, 0.1, 0.01, 0.001 nM rapamycinand test antibody for combination studies) and each dilution isperformed in triplicate wells. The cells plus antibody are thenincubated for 120 hours after which time the relative cell number ineach well is determined using the CellTiter-Glo luminescent cellviability assay (Promega). Luminescence (LU=Luminescence Units) isrecorded using a XFluor GENios Pro 4 and for data analysis the meanvalue from triplicate wells is taken and fitted by iterativecalculations using a sigmoidal curve analysis program (Graph Pad Prism)with variable Hill slope.

Western Blot Analysis of Phosphorylated AKT and PTEN Levels

SK-ES-1 cells are plated in 6-well plates in medium containing 10% fetalbovine serum and after overnight incubation they are treated with either100 nM isotype control antibody (a humanized IgG1 antibody targeted toCD44-v6) that does not bind IGF-1 or IGF-2, 100 nM 60819, 100 nMrapamycin, or a combination of 100 nM 60819 and 100 nM rapamycin. 24hours later the cells are lysed and the cell lysate frozen after theprotein concentration is determined by Bradford assay. Western blottingis performed by applying 30 μg of protein lysates to an SDS PAGE gel(BioRad) and the gel blotted on a Citerian gel blotting sandwich.Western blots are incubated overnight with a rabbit anti-beta actin(control) antibody, a rabbit anti-PTEN antibody (Cell Signaling #9559),or a rabbit anti-phospho-pAKT antibody (Cell Signaling #4060), at 1:5000(anti-beta actin), 1:1000 (anti-PTEN), or 1:2000 (anti-phosphoAKT)dilutions in 1% milk powder. Following washing in TBS an anti-rabbit IgGHRPO-conjugated secondary antibody (Amersham) is applied for 1 hour andafter further washes in TBS antibody reactivity is detected by ECL andcaptured on Hyperfilm (Amersham).

In Vitro Combination of Anti-IGF Antibody with EGFR Inhibitor inNSCLC-Derived Cell Line

The NSCLC-derived cell line A-549 (ATCC# CCL-185) is plated in 96-wellplates at a density of 1000 cells per well in RPMI 1640 mediumcontaining 2 mM L-glutamine and 10% fetal bovine serum and incubatedovernight at 37° C. and 5% CO₂ in a humidified atmosphere. The followingday a serial dilution of test IGF antibody, erlotinib/Tarceva, or acombination of test IGF antibody and erlotinib are added to the cells.The typical concentrations of the test IGF antibody used are 30000,10000, 3333, 1111, 370,123, 41, 14 ng/mL, and the typical concentrationof erlotinib used are 20000, 6667, 2222, 741, 247, 82, 27, 9 nM, andeach dilution is performed in triplicate wells. The cells are thenincubated for 120 hours after which time the relative cell number ineach well is determined using the CellTiter-Glo luminescent cellviability assay (Promega). Luminescence (LU=Luminescence Units) isrecorded using a XFluor GENios Pro 4 and for data analysis the meanvalue from triplicate wells is taken and fitted by iterativecalculations using a sigmoidal curve analysis program (Graph Pad Prism)with variable Hill slope.

Determination of the Effect on Total Murine and Total Rat Serum IGF-1Levels

Single intravenous (bolus) administrations of 25, 12.5, 6.25, and 3.13mg/kg of test IGF antibody are given to female athymic NMRI nude mice,6-8 weeks old (n=5). Single 10 minute intravenous administrations of 30,100, 200 mg/kg of antibody 60819 are given to male and female Wistar Hanrats, 6-8 weeks old (n=4 male, 4 female). Prior to antibody treatmentand 24 hours post administration a blood sample is taken, serumcollected, and total murine or rat IGF-1 levels determined using theOCTEIA rat/mouse total IGF-1 immunocytometric assay. The assay isperformed according to the manufacturer's instructions, absorbance ismeasured at 450 nm and evaluated using the SoftMax Pro software. Astandard curve is used to determine the serum concentration of totalIGF-1 in ng/ml. Statistical analysis is performed using the GraphPadPrism software.

Cell Based IGF-1R Phosphorylation ELISA

Mouse fibroblast cell lines recombinantly expressing human IGF-1R orhuman IR-A are maintained in DMEM supplemented with 10% heat inactivatedFCS, 1 mM sodium pyrovate, 0.075% sodium bicarbonate, MEM NEAA, and 0.3μg/ml puromycin at 37° C. and 5% CO₂ in a humidified incubator. Cellsare detached with trypsin/EDTA, resuspended in growth medium and dilutedto 100,000 cells/mL. 100 μL (10,000 cells) are seeded in wells of asterile 96-well plate and incubated overnight in a humidified incubatorat 37° C. and 5% CO₂. The cells are then starved with 100 μL/well assaymedium (DMEM supplemented with 0.5% heat inactivated FCS; 1 mM sodiumpyrovate, 0.075% sodium bicarbonate, and MEM NEAA) and incubatedovernight as before. A range of test antibody concentrations prepared inassay medium is added to the cells, all samples are prepared intriplicate to determine the standard deviation for each assay condition.An IGF-1R antibody, αIR-3 (Calbiochem, No. GR11L) is also tested inthese experiments. IGF-1 (20 ng/mL final concentration), IGF-2 (100ng/mL final concentration), or human serum (20% final concentration) isthen added and the plates incubated for 30 min in the humidifiedincubator. Cells are fixed by replacing the growth medium with 4%formaldehyde in PBS for 20 min at RT. After two wash cycles with 300μL/well wash buffer (PBS with 0.1% Triton X-100) for 5 min (withagitation) the cells are quenched with 100 μL/well 1.2 wt % hydrogenperoxide in wash buffer for 30 minutes at RT. Cells are washed againwith 300 μL/well washing buffer and blocked with 100 μL/well blockingbuffer (5% BSA in wash buffer) for 60 min at RT with agitation. Blockingbuffer is removed and 50 μl/well primary phopho-IGF-I receptor β(tyr1135/1136)/insulin receptor β (tyr1150/1151) antibody (CellSignaling, No. 3024) diluted 1:1000 in blocking buffer is added. Platesare incubated overnight at 4° C. with agitation then washed three timesas above and 50 μL/well anti-rabbit IgG goat immunoglobulins conjugatedwith horseradish peroxidase (Dako, No. P0448) diluted 1:500 in blockingbuffer is added. After a 60 min incubation at RT with agitation thewells are washed twice with washing buffer as above and once with 300 μLPBS. 100 μL/well TMB substrate solution (Bender MedSystems, No.BMS406.1000) is added to the wells and incubated for 10 min withagitation, following this the reaction is stopped by adding 100 μL/well1 M phosphoric acid and the absorbance read using a photometer (OD 450nm, OD 650 nm as reference) Inhibition of IGF-1R or IR-A phosphorylationIC₅₀ values are determined by graphical analysis.

Fab-IGF-1 Co-Crystallisation and Structure Determination

Monoclonal antibodies are prepared in a buffer of 100 mM Na-phosphate(pH 7.0) prior to papain digestion. Papain (Sigma Aldrich, P #3125) isactivated in digestion buffer (phosphate buffer containing 10 mMcysteine hydrochloride, 4 mM EDTA, pH 7.0) following the manufacturer'sinstructions. IgG antibody is mixed with the activated papain (ratioenzyme:IgG=1:100) and the reaction is incubated at 37° C. on a rotorshaker overnight. Digestion is stopped by adding iodacetamid to a finalconcentration of 30 mM. To separate the Fab fragment from Fc fragments,Fc cleavage products and intact Mab, the digestion mix is loaded onto aProtein A MabSelect column equilibrated with phosphate buffer. Thecolumn is washed with 5 column volumes of PBS, and the Fab fragment iscollected in the flow-through and wash fractions. The Fc fragment andintact Mab are eluted from the column with 100 mM citrate buffer (pH3.0) and subsequent size exclusion chromatography of the Fab fragment isperformed using a HiLoad Superdex 75 column. The column is run at 0.5 mLper min with 20 mM triethanolamine, 130 mM NaCl, pH 8.0. The proteinconcentration of Fab fragments is determined by measuring absorbance at280 nm Quality of Fab fragments is analysed by Western Blotting andELISA.

Fab-IGF-1 complex is generated by adding a 2-fold molar excess of therecombinant IGF-1 (Gropep; Receptor Grade) to the purified Fab which isthen incubated overnight on a rotor shaker at 4° C. Concentration of thecomplex to (15 mg/mL) and removal of unbound IGF-1 is performed using anAmicon-Ultra device. Crystallization of the Fab:IGF-1 complex is carriedout using various techniques such as hanging drop, sitting drop, andseeding. In one embodiment, the crystal is precipitated by contactingthe solution with a reservoir that reduces the solubility of theproteins due to presence of precipitants, i.e., reagents that induceprecipitation. Screening of various conditions lead to a suitable buffersystem manipulated by addition of a precipitant and additives. Theconcentration of the precipitants is preferably between 5-50% w/v. ThepH of the buffer is preferably about 3 to about 6. The concentration ofthe protein in the solution is preferably that of super-saturation toallow precipitation. The temperature during crystallization ispreferably between 4 and 25° C.

The three dimensional structure of Fab:IGF-1 complex as defined byatomic coordinates is obtained from the X-ray diffraction pattern of thecrystal and the electron density map derived there from. The diffractionof the crystals is better than 2 Å resolution. The crystals preferablyhave the space group P3221 (number 154) and unit cell dimensions ofapproximately =70 Å, b=70 Å, c=195 Å; and γ=120°. The method fordetermining the three dimensional structure is molecular replacementwhich involves use of the structure of a closely related molecule orreceptor ligand complex. Model building and refining is done in severaliterative steps to final R-factors (R and R_(free)) of 21 and 23%respectively.

Determination of Pharmacokinetic Parameters in Rats

Wistar rats are given five intravenous bolus administrations of 18, 52,and 248 mg/kg antibody every 72 hours. At various time points a bloodsample is taken and the human antibody concentration in the plasma isdetermined by sandwich ELISA. This allowed the mean pharmacokineticparameters of the antibody to be calculated on the first day of dosingand half-life is calculated after the last day of dosing (with t(n)=1008hours).

Example 1 Selection of High Affinity Antibodies that Bind IGF-1

In order to identify Fab fragments with improved affinity to humanIGF-1, several ‘parental’ Fab clones that are identified to bind IGF-1with low nanomolar affinity are subjected to ‘in vitro affinitymaturation’ where the L-CDR3 and H-CDR2 sequences of each clone areseparately diversified by substituting the parental sequence with alibrary of new L-CDR3 and H-CDR2 sequences. The resultant ‘maturationlibraries’ are subjected to solution pannings on human IGF-1 and theclones with the best affinity are selected for convertion into IgG1antibodies and tested further. The three antibodies with the best humanIGF-1 affinities are 60814, 60819, and 60833 which had affinities(K_(D)) of 180, 190, and 130 pM respectively (shown in Table 1) asdetermined by an electrochemiluminescence-based equilibrium titrationmethod.

TABLE 1 IGF-1 BINDING SUMMARY Antibody Affinity (pM) 60814 180 60819 19060833 130

The antibodies are also tested for their binding to human, murine, andrat IGF-1 and IGF-2, and human insulin, in immunosorbent assays. Thisdemonstrated that 60814, 60819, and 60833 show comparable cross-reactivebinding with mouse and rat IGF-1, and human, murine and rat IGF-2, butno reactivity to human insulin (at the highest concentration tested, 50ng/ml) (FIGS. 1A-1G).

Affinity constants for binding of the antibodies to human, mouse, andrat IGF-1 and IGF-2 is also determined by surface plasmon resonance(Biacore) analysis. The method involves capturing the antibodies on thesensor and flowing the IGF antigens over the captured antibodies, thusovercoming any avidity effect that could occur if the IGF antigens arecoated onto the sensor and the antibodies added. The affinity constantsusing this method for antibody 60833 are shown in Table 2 where it canbe seen that the measured K_(D) values for human IGF-1 and human IGF-2are 0.07 nM and 0.9 nM respectively.

TABLE 2 AFFINITY CONSTANTS OF ANTIBODY 60833 FOR HUMAN, MOUSE AND RATIGF-1 AND IGF-2 DETERMINED BY SURFACE PLASMON RESONANCE (ANTIBODYCAPTURE METHOD) Antigen K_(on) [M⁻¹s⁻¹] K_(off) [s⁻¹] K_(D) [nM] HumanIGF-1 4.74 × 10⁶ 3.01 × 10⁻⁴ 0.07 Mouse IGF-1 1.00 × 10⁶ 3.23 × 10⁻⁴0.33 Rat IGF-1 3.81 × 10⁶ 2.53 × 10⁻⁴ 0.07 Human IGF-2 3.97 × 10⁶ 3.53 ×10⁻³ 0.913 Mouse IGF-2 8.68 × 10⁵  1.1 × 10⁻² 13.4 Rat IGF-2 2.56 × 10⁶6.13 × 10⁻³ 2.41

Example 2 Inhibition of IGF Signalling

The first signalling event which occurs following binding of IGFs to theIGF-1R is the phosphorylation of the IGF-1R. A cell-based ELISA assay isused to measure the inhibition of IGF induced IGF-1R phosphorylation bythe antibody 60833. The potency and effectiveness (of up to 15 μg/mL(100 nM)) of 60833 in neutralising recombinant bioactive IGF-1 and IGF-2induced IGF-1R phosphorylation is determined. As shown in Table 3 andexample FIG. 2 60833 potently and effectively inhibits IGF-1 (FIG. 2A)and IGF-2 (FIG. 2B) induced signalling. In the same assay the IGF-1Rtargeted mAb αIR3 is much less potent and effective with respect toIGF-1 induced signalling, and displays a very weak effect on IGF-2induced signalling.

A similar cell based IR-A phosphorylation ELISA is used to demonstratethat 60833 can also inhibit IGF-2 signalling via IR-A. As shown in Table4 and example FIG. 3A, 60833 potently and effectively inhibits IGF-2induced IR-A phosphorylation. In contrast, αIR3, which cannot bind IR-A,shows no inhibitory effect.

The level of IGF bioactivity in human serum or plasma samples can alsobe measured using the IGF-1R phosphorylation cell based ELISA. This isused to determine the potency and effectiveness (up to 15 μg/mL (100nM)) of 60833 in neutralising human serum IGF bioactivity. As shown inTable 3 and example FIG. 3B 60833 potently and effectively inhibits IGFbioactivity in human serum.

TABLE 3 EFFECT OF 60833 ON IGF-1R PHOSPHORYLATION IGF-1R % RemainingPhosphorylation IC₅₀ Phosphorylation at 15 μg/mL Stimulus Inhibitor(μg/mL) (100 nM) Inhibitor IGF-1 60833 0.09 0 (20 ng/mL) αIR3 1.16 35Control IgG >15 108 IGF-2 60833 1.12 7 (100 ng/mL) αIR3 >15 76 ControlIgG >15 108 Human Serum 60833 0.25 5 Pooled from αIR3 >15 120 HealthyDonors Control IgG >15 110 (20%)

TABLE 4 EFFECT OF 60833 ON IR-A PHOSPHORYLATION IR-A % RemainingPhosphorylation IC₅₀ Phosphorylation at 15 μg/mL Stimulus Inhibitor(μg/mL) (100 nM) Inhibitor IGF-2 60833 0.82 6 (100 ng/mL) αIR3 >15 115Control IgG >15 109

Example 3 Effects on IGF-1 and IGF-2-Induced Cell Proliferation

The effects of antibodies 60814, 60819, and 60833 on IGF-1 and IGF-2induced MCF-7 (breast cancer derived) and COLO 205 (colon cancerderived) cell line proliferation is determined Examples of the effectsof antibodies 60814 and 60819 are shown in FIGS. 4A-D. All threeantibodies show a dose dependent inhibition of IGF-1 (FIGS. 4A and 4C)and IGF-2 (FIGS. 4B and 4D) induced MCF-7 (FIGS. 4A and 4B) and COLO 205(FIGS. 4C and 4D) cell proliferation. The concentration of each antibodyrequired to inhibit 50% of the IGF-1 or IGF-2 induced proliferation ofeach cell line is shown in Table 5.

TABLE 5 INHIBITION OF IGF-1 AND IGF-2 INDUCED PROLIFERATION OF THE MCF-7AND COLO 205 CANCER CELL LINES IC₅₀ (ng/ml) Cell Line Stimulation 6081460819 60833 MCF7 IGF-1 24.1 54.0 38.6 MCF7 IGF-2 78.2 40.8 81.2 COLO-205IGF-1 135.0 216.9 165.1 COLO 205 IGF-2 576.1 100.8 632.3

Example 4 Effects on Proliferation of Ewing's Sarcoma-Derived Cell Lines

The effect of antibodies 60819 and 60833 on the proliferation of theEwing's sarcoma-derived cell line TC-71 grown in medium containing 10%FCS is shown in FIG. 5. Relative to a humanized IgG1 isotype controlantibody, that does not bind IGF-1 or IGF-2, both 60819 and 60833 show adose-dependent inhibition of TC-71 cell proliferation.

Example 5 Effect on Total Murine and Rat IGF-1 Levels

Neutralization of active IGF-1 with an IGF targeted antibody may beexpected to result in an endocrine feedback through the GH pathway whichresults in elevated total serum IGF-1 levels. Antibodies 60814, 60819,and 60833 are cross-reactive with mouse and rat IGF-1 which allows anypharmacodynamic effect on total serum IGF-1 levels to be measured inthese species. As shown in FIGS. 6 and 7, administration of antibody60819 to mice (FIG. 6) and rats (FIG. 7) results in a dose dependentelevation of serum total murine and rat IGF-1 levels 24 hours postadministration. This represents a useful pharmacodynamic marker of theactivity of these antibodies which can be tested during clinicaldevelopment in humans.

Example 6 Effect of Combination of IGF Ligand Targeting Antibodies andRapamycin on Ewing's Sarcoma-Derived Cell Line Proliferation andIntracellular Signaling

The effect of antibody 60819 and the mTOR inhibitor rapamycin, alone orin combination, on the proliferation of the Ewing's sarcoma-derived cellline SK-ES-1 is shown in FIG. 8. There is a dose dependent inhibition ofproliferation with both antibody 60819 and rapamycin alone, with bothsingle agents achieving around 60% proliferation inhibition at 100 nM.Combination of equivalent doses of both antibody 60819 and rapamycindemonstrated an additive effect on the inhibition of cell proliferationwith approximately 95% inhibition when 100 nM doses are combined.

IGF-induced cell proliferation is mediated via a chain of intracellularprotein phosphorylation events. One protein whose phosphorylation isincreased by IGF stimulation is AKT. FIG. 9 demonstrates the effect ofantibody 60819 and rapamycin, alone or in combination, on thephosphorylation of AKT in SK-ES-1 cells 24 hours following treatmentusing 100 nM doses. Compared with proliferating untreated cells whichshow phosphorylation of AKT, 100 nM antibody 60819 inhibited AKTphosphorylation. Conversely, 100 nM rapamycin treatment resulted inhigher levels of phosphorylated AKT than the control which is thought tobe due to a compensatory feedback mechanism following mTOR inhibition.However, when 100 nM rapamycin and 100 nM antibody 60819 are combinedthe phosphorylation of AKT is inhibited. This suggests that thecompensatory feedback which leads to phosphorylated AKT upon rapamycintreatment is due to elevation of the IGF ligands and these are inhibitedby antibody 60819. FIG. 9 also demonstrates that both antibody 60819 andrapamycin, alone or in combination, do not affect the total levels ofPTEN.

Example 7 Effect of Combination of an IGF Ligand Targeting Antibody andan EGFR Inhibitor on NSCLC-Derived Cell Line Proliferation

The effect of antibody 60819 and the EGFR inhibitor erlotinib/tarceva,alone or in combination, on the proliferation of the NSCLC-derived cellline A-549 is shown in FIG. 10. In this model, there is only a smalleffect of antibody 60819 alone on cell proliferation whilst tarcevashows a dose dependent effect with around 60% cell proliferationinhibition at the highest dose tested (20 μM). However, when antibody60819 and tarceva are combined there is a more potent and effectiveinhibition of cell proliferation indicative of a synergistic effect.

Example 8 Pharmacokinetic Properties in Wistar Rats

The mean pharmacokinetic parameters of antibody 60833 in Wistar rats onthe first day of dosing with 18, 52, and 248 mg/kg is shown in Table 6.Terminal half-life was calculated after the last day of dosing (witht(n)=1008 hours), the average terminal half-life for all three doselevels is 221 hr (9.2 days).

TABLE 6 MEAN PHARMACOKINETIC PARAMTERES OF ANTIBODY 60833 IN WISTAR RATSON FIRST DAY OF DOSING 60833 Dose (mg/kg) 18 52 248 C(max) [mg/mL] 0.5311.70 5.56 AUC(0-72 h) [mg · h/mL] 15.5 40.2 120 CL [(mL/day)/kg] 22.928.7 37.3 V(ss) [mL/kg] 68.1 76.3 65.4 t½^(φ) [hr] 210 197 255 ^(φ)=after last day of dosing with t(n) = 1008 hr

Example 9 Fab-IGF-1 Co-Crystallisation and Structure Determination toIdentify Antibody Binding Sites on IGF-1

To definitively determine the residues on human IGF-1 that interact withthe IGF antibodies the Fab and IGF-1 were co-crystallised and thestructure of the interaction determined with better than 2 Å resolution.The residues on IGF-1 that are contacted by antibody (Fab) 60833 areshown in Table 7. In total 19 residues on IGF-1 make contact with 15 CDRresidues on 60833. Of these 19 IGF-1 residues 17 are identical in humanIGF-2 when the human IGF-1 and IGF-2 amino acid sequences are aligned(listed in Table 7). FIG. 11 shows the 3D structure of IGF-1 with theamino acids that are bound by 60833 highlighted, the linear amino acidsequence of human IGF-1 is also shown with the interacting amino acidsunderlined.

TABLE 7 RESIDUES IN HUMAN IGF-1 THAT MAKE CONTACTS WITH RESIDUES OF60833 FAB IGF-1 residues in Contact residues on Homologous contact with60833 60833 (CDR) residue on IGF-2 Leu (L) 5 Tyr (Y) 54; (HCDR 2) Leu(L) 8 Cys (C) 6 Ser (S) 56; (HCDR 2) Cys (C) 9 Glu (E) 9 Thr (T) 52;(HCDR 2) Glu (E) 12 Ser (S) 53; (HCDR 2) Tyr (Y) 54; (HCDR 2) Gly (G)55; (HCDR 2) Ser (S) 56; (HCDR 2) Leu (L) 10 Phe (F) 57; (HCDR 2) Leu(L) 13 Asp (D) 12 Trp (W) 33; (HCDR 1) Asp (D) 15 Ala (A) 13 Trp (W) 33;(HCDR 1) — Phe (F) 16 Trp (W) 33; (HCDR 1) Phe (F) 19 Arg (R) 92; (LCDR3) Tyr (Y) 98; (LCDR 3) Trp (W) 99; (LCDR 3) Tyr (Y) 101; (HCDR 3) Val(V)17 Arg (R) 92; (LCDR 3) Val (V) 20 Tyr (Y) 98; (LCDR 3) Arg (R) 21Tyr (Y) 95; (LCDR 3) Arg (R) 24 Cys (C) 47 Ser (S) 56; (HCDR 2) Cys (C)46 Phe (F) 57; (HCDR 2) Cys (C) 48 Ser (S) 56; (HCDR 2) Cys (C) 47 Phe(F) 49 Tyr (Y) 54; (HCDR 2) Phe (F) 48 Gly (G) 55; (HCDR 2) Ser (S) 56;(HCDR 2) Ser (S) 51 Gly (G) 55; (HCDR2) Ser (S) 50 Ser (S) 56; (HCDR 2)Thr (T) 58; (HCDR 2) Cys (C) 52 Ser (S) 56; (HCDR 2) Cys (C) 51 Phe (F)57; (HCDR 2) Thr (T) 58; (HCDR 2) Asp (D) 53 Phe (F) 57; (HCDR 2) Asp(D) 52 Thr (T) 58; (HCDR 2) Leu (L) 54 Trp (W) 33; (HCDR 1) Leu (L) 53Phe (F) 57; (HCDR 2) Thr (T) 58; (HCDR 2) Tyr (Y) 98; (LCDR 3) Arg (R)55 Lys (K) 65; (HCDR 2) — Gly (G) 96; (LCDR 3) Tyr (Y) 98; (LCDR 3) Leu(L) 57 Phe (F) 57; (HCDR 2) Leu (L) 56 Glu (E) 58 Tyr (Y) 95; (LCDR 3)Glu (E) 57 Gly (G) 96; (LCDR 3) Tyr (Y) 98; (LCDR 3) 19 residues on IGF-15 residues on 60833 1_involved in involved in contacts with IGF-1:contact with 60833 HCDR 1: 1 residues HCDR 2: 8 residues HCDR 3: 1residues LCDR 1: — LCDR 2: — LCDR 3: 5 residues

REFERENCES

-   Barbas, et al., 1994, Proc. Nat. Acad. Sci, USA 91:3809-3813.-   Burtrum et al., Cancer Res. 63: 8912-21, 2003).-   Chen et al., J. Clin. Endocrinol. 90: 366-371, 2005.-   Cui et al., Science 299: 1753-55, 2003.-   Cruz-Correa et al., Gastroenterology 126: 1190-3, 2004.-   Dufner and Thomas, Exp. Cell Res. 253: 100-109, 1999.-   Frasca et al., Mol. Cell. Biol. 19: 3278-88, 1999.-   Freier et al., Gut, May; 44(5): 704-08, 1999;-   Fukuzawa et al., Int. J. Cancer 82: 490-497, 1999.-   Goetsch et al., Int. J. Cancer 113: 316-28, 2005.-   Goya et al., Cancer Res. 64: 6252-58, 2004.-   Haenel et al., Anal. Biochem. 339: 182-184, 2005.-   Hassan et al., Cancer Res. 60: 1070-6, 2000-   Hawkins et al., 1992, J. MoI. Biol. 226(3): 889 896.-   Jackson et al., 1995, J. Immunol. 154(7):3310-9.-   Jerome et al., End. Rel. Cancer 10: 561-578, 2003.-   Kabat et al., Sequences of Proteins of Immunological Interest (5th    Ed.). NIH Publication No. 91 3242. U.S. Department of Health and    Human Services, Public Health Service, National Institutes of    Health, Bethesda, Md. (1991).-   Kipriyanow and Le Gall, Molecular Biotechnology 26: 39-60, 2004.-   Knappik et al., J. Mol. Biol. 296: 57-86, 2000.-   Kolb et al. Pediatr. Blood Cancer 50: 1190-1197, 2008.-   Krebs, B. et al., J. Immunol. Meth. 245: 67 84, 2001.-   Kulik et al., Mol. Cell. Biol. 17: 1595-606, 1997.-   LeRoith D, Experimental Diab. Res. 4: 205-212, 2003.-   Li et al., Tumour Biol. 25: 62-8, 2004.-   Lowman et al., Biochemistry 30(45): 10832-10837, 1991.-   Lund et al., Cancer Lett. 206: 85-96, 2004.-   Manara et al., Clin. Cancer Res. 13: 1322-1330, 2007.-   Manes et al., Endocrinology 138: 905-915, 1997.-   Marks et al., 1992, Biotechnology 10:779-783.-   Miyamoto et al., Clin. Cancer Res. 11: 3494-3502, 2005.-   Moorhead et al., Oncogene 22: 853-7, 2003.-   Nagy et al., Nature Med. 8(8): 801-807, 2002.-   Ng et al., J. Gastroenterol. Hepatol. 13: 152-7, 1998.-   Pandini et al., J. Biol. Chem. 277: 39684-95, 2002.-   Pollack et al., Nature Rev. Can. 4: 505-518, 2004.-   Pollack et al., American Society for Clinical Oncology (ASCO),    Annual Meeting 2007, abstract 3587.-   Quinn et al., J. Biol. Chem. 271: 11477-83, 1996.-   Rauchenberger, R. et al., J. Biol. Chem. 278: 38194-38205, 2003.-   Reinberg, U.S. News World Report, Mar. 5, 2008.-   Remington: “The Science and Practice of Pharmacy”, 2005, 21^(st)    edition, Hendrickson Randy, Editor; Advanced Concepts Institute,    University of The Sciences in Philadelphia, 600 S. 43^(rd) Street,    Philadelphia, Pa. 19104, USA; 215-895-1184.-   Renehan et al., Br. J. Cancer 83: 1344-50, 2000a).-   Renehan et al., J. Clin. Endocrinol. Metab. 85: 3402-8, 2000b).-   Revets et al., Expert Opin Biol Ther. 5(1):111-24, 2005.-   Rubin et al., Lab. Invest. 73: 311-31, 1995.-   Russell et al., Proc. Natl. Acad. Sci. USA 81: 2389-2392, 1984.-   Scotlandi et al., Cancer Res. 56: 4570-4574, 1996.-   Sell et al., Natl. Acad. Sci. USA 90: 11217-21, 1993.-   Sell et al., Mol. Cell. Biol. 14: 3604-12, 1994.-   Shier et al., 1995, Gene 169:147-155.-   Shukla et al., 2007, J. Chromatography B, 848(1): 28-39-   Srinivasan, M. and Roeske, R W., Curr Protein Pept Sci. 2005, April;    6(2):185-96.-   Strumberg D., 2005, Drugs Today (Barc). 2005 December; 41(12):773-84-   Takanami et al., J. Surg. Oncol. 61: 205-8, 1996.-   Tsai et al., Scand. J. Gastroenterol. 40: 68-75, 2005.-   Wang et al., World J. Gastroenterol. 9: 267-70, 2003.-   Woodson et al., J. Natl. Cancer Inst. 96: 407-10, 2004.-   Yao et al., Clin. Cancer Res. 9: 2719-26, 2003a).-   Yao et al., J. Clin. Invest. 111: 265-273, 2003b).-   Yelton et al., 1995, Immunol. 155:1994-2004.-   Zapata et al., Protein Eng. 8(10): 1057-1062., 1995.-   Zhao et al., Cancer Epidemiol. Biomarkers Prev. 14: 1819-22, 2005.-   WO 89/011297-   WO 94/29348-   WO 02/056910-   WO 03/002609-   WO 03/050531-   WO 03/093317-   WO 04/003019-   WO 04/058821-   WO 2005/018671-   WO 2005/027970-   WO 2005/028515-   WO 2007/042309-   WO 2007/070432-   JP 2003-310275-   U.S. Pat. No. 4,342,566-   U.S. Pat. No. 3,773,919-   U.S. Pat. No. 6,696,245-   U.S. Pat. No. 6,991,790-   U.S. Pat. No. 7,060,268

1-18. (canceled) 19) A DNA molecule encoding the variable heavy chain orthe variable light chain of an antibody molecule, which a) binds tohuman IGF-1 and IGF-2 such that i) binding of IGF-1 and IGF-2 to theIGF-1 receptor is prevented and ii) IGF-1 receptor-mediated signaling isinhibited, b) binds to mouse and rat IGF-1 and IGF-2, c) does not bindto human insulin; wherein said antibody molecule is selected from thegroup comprising i) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2(CDR2) and SEQ ID NO:3 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) andSEQ ID NO:6 (CDR3); ii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12(CDR2) and SEQ ID NO:13 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) andSEQ ID NO:16 (CDR3); iii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22(CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) andSEQ ID NO:26 (CDR3), or a fragment or variant thereof. 20) The DNAmolecule of claim 19 which has the nucleotide sequence of SEQ ID NO:7,17 or
 27. 21) The DNA molecule of claim 19 which has the nucleotidesequence of SEQ ID NO:9, 19 or
 29. 22) An expression vector containing aDNA molecule comprising the nucleotide sequence encoding the variableheavy chain and/or the variable light chain of an antibody molecule,which a) binds to human IGF-1 and IGF-2 such that i) binding of IGF-1and IGF-2 to the IGF-1 receptor is prevented and ii) IGF-1receptor-mediated signaling is inhibited, b) binds to mouse and ratIGF-1 and IGF-2, c) does not bind to human insulin; wherein saidantibody molecule is selected from the group comprising i) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) and SEQ ID NO:3 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6 (CDR3); ii) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) and SEQ ID NO:13 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ ID NO:16 (CDR3); iii) anantibody molecule that has heavy chain CDRs comprising the amino acidsequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) and SEQ ID NO:23(CDR3) and that has light chain CDRs comprising the amino acid sequencesof SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26 (CDR3). 23)The expression vector of claim 22 containing a DNA molecule comprisingthe nucleotide sequence of SEQ ID NO:7 and/or SEQ ID NO:9, or comprisingthe sequence of SEQ ID NO:17 and/or SEQ ID NO:19, or comprising thesequence of SEQ ID NO:27 and/or SEQ ID NO:29. 24) The expression vectorof claim 22, comprising, in addition, a DNA molecule encoding theconstant heavy chain and/or the constant light chain, respectively,linked to the DNA molecule encoding the variable heavy chain and/or thevariable light chain, respectively. 25) A host cell carrying one or moreexpression vectors of claim
 22. 26) The host cell of claim 25, which isa mammalian cell. 27) A method for producing an antibody, comprisingtransfecting a mammalian host cell with one or more vectors of claim 22,cultivating the host cell and recovering and purifying the antibody. 28)A method for producing an antibody, comprising obtaining a mammalianhost cell comprising one or more vectors of claim 22, and cultivatingthe host cell. 29) The method according to claim 28, further comprisingrecovering and purifying the antibody.
 30. (canceled) 31) A method oftreating a cancerous disease selected from cancers of the hematopoieticsystem including leukemias, lymphomas and myelomas, cancers of thegastrointestinal tract including esophageal, gastric, colorectal,pancreatic, liver and gall bladder cancer and bile duct cancer, inparticular hepatocellular carcinoma; kidney, prostate and bladdercancer; gynecological cancers including breast, ovarian, cervical andendometrial cancer; skin and head and neck cancers including malignantmelanomas; pediatric cancers like Wilms' tumour, neuroblastoma andEwing's sarcoma; brain cancers like glioblastoma; sarcomas likeosteosarcoma, soft tissue sarcoma, rhabdomyosarcoma, hemangiosarcoma;lung cancer, in particular non-small cell lung cancer; mesothelioma andthyroid cancer comprising administering to a patient an antibodymolecule, which a) binds to human IGF-1 and IGF-2 such that i) bindingof IGF-1 and IGF-2 to the IGF-1 receptor is prevented and ii) IGF-1receptor-mediated signaling is inhibited, b) binds to mouse and ratIGF-1 and IGF-2, c) does not bind to human insulin; wherein saidantibody molecule is selected from the group comprising i) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) and SEQ ID NO:3 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6 (CDR3); ii) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) and SEQ ID NO:13 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ ID NO:16 (CDR3); iii) anantibody molecule that has heavy chain CDRs comprising the amino acidsequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) and SEQ ID NO:23(CDR3) and that has light chain CDRs comprising the amino acid sequencesof SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26 (CDR3). 32)The method of claim 31, wherein the antibody is to be used incombination with platinum-based chemotherapy, in particularpaclitaxel/carboplatin or gemcitabine/cisplatin platinum doublettherapy, sorafenib, or a compound selected from the group of inhibitorsof EGFR, VEGF, HER2-neu, AuroraB, Plk1, PI3 kinase, or mTor. 33.(canceled) 34) A pharmaceutical composition comprising an antibodymolecule, which a) binds to human IGF-1 and IGF-2 such that i) bindingof IGF-1 and IGF-2 to the IGF-1 receptor is prevented and ii) IGF-1receptor-mediated signaling is inhibited, b) binds to mouse and ratIGF-1 and IGF-2, c) does not bind to human insulin; wherein saidantibody molecule is selected from the group comprising i) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) and SEQ ID NO:3 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6 (CDR3); ii) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) and SEQ ID NO:13 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ ID NO:16 (CDR3); iii) anantibody molecule that has heavy chain CDRs comprising the amino acidsequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) and SEQ ID NO:23(CDR3) and that has light chain CDRs comprising the amino acid sequencesof SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26 (CDR3) anda pharmaceutically acceptable carrier, further comprising one or moreadditional therapeutic agents selected from a) DNA damaging agents, b)therapeutically active compounds that inhibit signal transductionpathways or mitotic checkpoints in cancer cells, c) antidiabetics. 35)The pharmaceutical composition of claim 34, wherein said one or morecompounds b) is selected from the group of inhibitors of EGFR, VEGF,HER2-neu, AuroraB, Plk1, PI3 kinase, or mTor. 36) A pharmaceuticalcomposition comprising an antibody molecule, which a) binds to humanIGF-1 and IGF-2 such that i) binding of IGF-1 and IGF-2 to the IGF-1receptor is prevented and ii) IGF-1 receptor-mediated signaling isinhibited, b) binds to mouse and rat IGF-1 and IGF-2, c) does not bindto human insulin; wherein said antibody molecule is selected from thegroup comprising i) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2(CDR2) and SEQ ID NO:3 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) andSEQ ID NO:6 (CDR3); ii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12(CDR2) and SEQ ID NO:13 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) andSEQ ID NO:16 (CDR3); iii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22(CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) andSEQ ID NO:26 (CDR3) and a pharmaceutically acceptable carrier for thetreatment of a cancerous disease selected from cancers of thehematopoietic system including leukemias, lymphomas and myelomas,cancers of the gastrointestinal tract including esophageal, gastric,colorectal, pancreatic, liver and gall bladder cancer and bile ductcancer, in particular hepatocellular carcinoma; kidney, prostate andbladder cancer; gynecological cancers including breast, ovarian,cervical and endometrial cancer; skin and head and neck cancersincluding malignant melanomas; pediatric cancers like Wilms' tumour,neuroblastoma and Ewing's sarcoma; brain cancers like glioblastoma;sarcomas like osteosarcoma, soft tissue sarcoma, rhabdomyosarcoma,hemangiosarcoma; lung cancer, in particular non-small cell lung cancer;mesothelioma and thyroid cancer. 37) The pharmaceutical composition ofclaim 36, to be further used in combination with platinum-basedchemotherapy, in particular paclitaxel/carboplatin orgemcitabine/cisplatin platinum doublet therapy, sorafenib, or a compoundselected from the group of inhibitors of EGFR, VEGF, HER2-neu, AuroraB,Plk1, PI3 kinase, or mTor. 38) A method for treating a patient sufferingfrom a cancerous disease selected from cancers of the hematopoieticsystem including leukemias, lymphomas and myelomas, cancers of thegastrointestinal tract including esophageal, gastric, colorectal,pancreatic, liver and gall bladder cancer and bile duct cancer, inparticular hepatocellular carcinoma; kidney, prostate and bladdercancer; gynecological cancers including breast, ovarian, cervical andendometrial cancer; skin and head and neck cancers including malignantmelanomas; pediatric cancers like Wilms' tumour, neuroblastoma andEwing's sarcoma; brain cancers like glioblastoma; sarcomas likeosteosarcoma, soft tissue sarcoma, rhabdomyosarcoma, hemangiosarcoma;lung cancer, in particular non-small cell lung cancer; mesothelioma andthyroid cancer, comprising administering to said patient an effectiveamount of a pharmaceutical composition comprising an antibody molecule,which a) binds to human IGF-1 and IGF-2 such that i) binding of IGF-1and IGF-2 to the IGF-1 receptor is prevented and ii) IGF-1receptor-mediated signaling is inhibited, b) binds to mouse and ratIGF-1 and IGF-2, c) does not bind to human insulin; wherein saidantibody molecule is selected from the group comprising i) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) and SEQ ID NO:3 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6 (CDR3); ii) an antibodymolecule that has heavy chain CDRs comprising the amino acid sequencesof SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) and SEQ ID NO:13 (CDR3) andthat has light chain CDRs comprising the amino acid sequences of SEQ IDNO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ ID NO:16 (CDR3); iii) anantibody molecule that has heavy chain CDRs comprising the amino acidsequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22 (CDR2) and SEQ ID NO:23(CDR3) and that has light chain CDRs comprising the amino acid sequencesof SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) and SEQ ID NO:26 (CDR3) anda pharmaceutically acceptable carrier. 39) The method of claim 38,wherein additionally an effective amount of paclitaxel/carboplatin orgemcitabine/cisplatin, sorafenib, or a compound selected from the groupof inhibitors of EGFR, VEGF, HER2-neu, AuroraB, Plk1, PI3 kinase or mToris administered to the patient. 40) A method for inhibiting the bindingof IGF-1 and IGF-2 to the IGF-1 receptor in a mammalian cell, comprisingadministering to said cell an antibody molecule which a) binds to humanIGF-1 and IGF-2 such that i) binding of IGF-1 and IGF-2 to the IGF-1receptor is prevented and ii) IGF-1 receptor-mediated signaling isinhibited, b) binds to mouse and rat IGF-1 and IGF-2, c) does not bindto human insulin; wherein said antibody molecule is selected from thegroup comprising i) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2(CDR2) and SEQ ID NO:3 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) andSEQ ID NO:6 (CDR3); ii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12(CDR2) and SEQ ID NO:13 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) andSEQ ID NO:16 (CDR3); iii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22(CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) andSEQ ID NO:26 (CDR3), whereby signaling mediated by the IGF-1 receptorand proliferation and anti-apoptosis mediated by IGF-1 and IGF-2 areinhibited. 41) A method for inhibiting the binding of IGF-2 to theinsulin receptor IR-A in a mammalian cell, comprising administering tosaid cell an antibody molecule which a) binds to human IGF-1 and IGF-2such that i) binding of IGF-1 and IGF-2 to the IGF-1 receptor isprevented and ii) IGF-1 receptor-mediated signaling is inhibited, b)binds to mouse and rat IGF-1 and IGF-2, c) does not bind to humaninsulin; wherein said antibody molecule is selected from the groupcomprising i) an antibody molecule that has heavy chain CDRs comprisingthe amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2 (CDR2) andSEQ ID NO:3 (CDR3) and that has light chain CDRs comprising the aminoacid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) and SEQ ID NO:6(CDR3); ii) an antibody molecule that has heavy chain CDRs comprisingthe amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12 (CDR2) andSEQ ID NO:13 (CDR3) and that has light chain CDRs comprising the aminoacid sequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) and SEQ IDNO:16 (CDR3); iii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22(CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) andSEQ ID NO:26 (CDR3), whereby signaling mediated by the insulin receptorIR-A is inhibited and whereby proliferation and anti-apoptosis mediatedby IGF-2 is inhibited. 42) The method of claim 40, wherein saidadministering is done in vitro. 43) A method for monitoring theeffectiveness of a treatment of a cancer patient with an antibodymolecule that binds to IGF-1 and IGF-2, wherein said method comprises(a) measuring, in a biological sample of said patient, the level oftotal IGF-1, (b) administering to said patient said anti-IGF antibodymolecule, (c) measuring, in a biological sample of said patient, thelevel of total IGF-1, wherein the amount of increase in the level oftotal IGF-1, compared with the level of total IGF-1 measured in step(a), indicates to which extent the patient responds to the treatmentwith said anti-IGF antibody molecule. 44) The method of claim 43,wherein said antibody molecule is an antibody molecule which a) binds tohuman IGF-1 and IGF-2 such that i) binding of IGF-1 and IGF-2 to theIGF-1 receptor is prevented and ii) IGF-1 receptor-mediated signaling isinhibited, b) binds to mouse and rat IGF-1 and IGF-2, c) does not bindto human insulin; wherein said antibody molecule is selected from thegroup comprising i) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:1 (CDR1), SEQ ID NO:2(CDR2) and SEQ ID NO:3 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:4 (CDR1), SEQ ID NO:5 (CDR2) andSEQ ID NO:6 (CDR3); ii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:11 (CDR1), SEQ ID NO:12(CDR2) and SEQ ID NO:13 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:14 (CDR1), SEQ ID NO:15 (CDR2) andSEQ ID NO:16 (CDR3); iii) an antibody molecule that has heavy chain CDRscomprising the amino acid sequences of SEQ ID NO:21 (CDR1), SEQ ID NO:22(CDR2) and SEQ ID NO:23 (CDR3) and that has light chain CDRs comprisingthe amino acid sequences of SEQ ID NO:24 (CDR1), SEQ ID NO:25 (CDR2) andSEQ ID NO:26 (CDR3). 45.-47. (canceled)